Application of Computer-Aided Designing and Rapid Prototyping Technologies in Reconstruction of Blowout Fractures of the Orbital Floor

Abstract

Introduction: Traumatology of the maxillofacial region represents a wide range of different types of facial skeletal injuries and encompasses numerous treatment methods. Application of computer-aided design (CAD) in combination with rapid prototyping (RP) technologies and three-dimensional computed tomography techniques facilitates surgical therapy planning for efficient treatment. Objective: The purpose of this study is to determine the efficiency of individually designed implants of poly-DL-lactide (PDLLA) in the reconstruction of blowout fractures of the orbital floor. Methods: In the course of a surgical treatment, individually designed implants manufactured by CAD/RP technologies were used. Preoperative analysis and postoperative monitoring were conducted to evaluate the successfulness of orbital floor reconstruction using customized PDLLA implants, based on: presence of diplopia, paresthesia of infraorbital nerve, and presence of enophthalmos. Results: In 6 of the 10 patients, diplopia completely disappeared immediately after surgical procedure. Diplopia gradually disappeared after 1 month in 3 patients, whereas in 1, it remained even after 6 months. In 7 patients, paresthesia disappeared within a month after surgery and in 3 patients within 2 months. Postoperative average Orbital volume (OV) of the injured side (13.333 +/- 3.177) was significantly reduced in comparison with preoperative OV (15.847 +/- 3.361) after reconstruction of the orbital floor with customized PDLLA implant (P lt 0.001). Thus, average OV of corrected orbit was not different compared with the OV of the uninjured orbit (P = 0.981). Conclusions: Reconstruction of blowout fractures of the orbital floor by an individually designed PDLLA implant combined with virtual preoperative modeling allows easier preoperative preparation and yields satisfactory functional and esthetic outcomes.