title: Personalized Reconstruction of Traumatic Orbital Defects Based on Precise Three-Dimensional Orientation and Measurements of the Globe.
abstract: OBJECTIVE
  The aim of the study was to precisely assess the severity of traumatic orbital defects and techniques for personalized orbital reconstruction.
  
  
  METHODS
  A retrospective study was conducted in 97 patients with traumatic orbital defects who were treated in our hospital between July 2003 and June 2012. Pre- and postoperative spiral computed tomography scans were performed in all patients. A spatial orientation technique was used to measure the three-dimensional position of the globe and calculate the changes in the orbital volume. Subsequently, a computer-assisted technique and a rapid prototyping technique were used to create a personalized orbital model to aid in the planning of surgery as well as the preforming of implants and bone plates. During surgery, the herniated orbital contents were returned; the preformed titanium mesh, Medpor, or other implants were placed; the orbital shape in the defect site was precisely restored; and normal proportions between the orbital walls and orbital contents were regained. The treatment outcomes were evaluated with respect to postoperative appearance, patients' satisfaction, ophthalmologic examination, and computed tomography scan. The complications were analyzed accordingly.
  
  
  RESULTS
  Satisfactory results were achieved in all patients with the following exceptions: 1 patient with an unsatisfactory facial appearance; 2 patients with old trauma and an unfavorable correction of enophthalmos who experienced diplopia with no significant improvement within 6 months after surgery; and 2 patients of mild postoperative lower eyelid ectropion. All other patients achieved satisfactory treatment effects, that is, the orbital shape in the defect site was precisely restored, and normal proportions between the orbital walls and orbital contents were regained. There were no other severe complications reported.
  
  
  CONCLUSIONS
  In patients with traumatic orbital defects, accurate digital evaluations of the three-dimensional position of the globe and changes in the orbital volume aid in surgical planning with a personalized model and promote early surgery with minimal trauma. When the orbital volume was restored and the position of the globe was maintained or corrected, the precise reconstruction of the anatomic shape of the orbit was concurrently completed. Personalized orbital reconstruction can improve the efficacy of plastic surgery in patients with orbital deformities.
authors.affiliation: *Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Fujian Medical University; Research Institute of Facial Restoration and Reconstruction, Fujian Medical University †Department of Mathematics Physical and Computer Education, Fujian Medical University, Fuzhou, Fujian Province, China.
authors.forename: Li
authors.initials: L
authors.lastname: Huang
authors.forename: Lisong
authors.initials: L
authors.lastname: Lin
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Wang
authors.forename: Bin
authors.initials: B
authors.lastname: Shi
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Zhu
authors.forename: Yu
authors.initials: Y
authors.lastname: Qiu
authors.forename: Yue
authors.initials: Y
authors.lastname: Huang
authors.forename: Xueyuan
authors.initials: X
authors.lastname: Yu
authors.forename: Yunyang
authors.initials: Y
authors.lastname: Liao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D009917:Orbital Fractures / Q000175:diagnosis / Q000601:surgery*; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D014025:Titanium; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
chemical_list: D014025:Titanium