A nonsurgical approach with repeated orthoptic evaluation is justified for most blow-out fractures.

Objective: This study presents the results of an updated clinical protocol for orbital blow-out fractures, with a special emphasis on nonsurgical treatment and orthoptic evaluation of functional improvement.

Methods: A two-centre multidisciplinary prospective cohort study was designed to monitor the results of a clinical protocol by assessing ductions, diplopia, globe position, and fracture size. Patients underwent clinical assessment and orthoptic evaluation at first presentation and then at 2 weeks and 3/6/12 months after nonsurgical or surgical treatment.

The advantages of advanced computer-assisted diagnostics and three-dimensional preoperative planning on implant position in orbital reconstruction.

Objective: Advanced three-dimensional (3D) diagnostics and preoperative planning are the first steps in computer-assisted surgery (CAS). They are an integral part of the workflow, and allow the surgeon to adequately assess the fracture and to perform virtual surgery to find the optimal implant position. The goal of this study was to evaluate the accuracy and predictability of 3D diagnostics and preoperative virtual planning without intraoperative navigation in orbital reconstruction.

Should Virtual Mirroring Be Used in the Preoperative Planning of an Orbital Reconstruction?

Purpose: Mirroring has been used as a diagnostic tool in orbital wall fractures for many years, but limited research is available proving the assumed symmetry of orbits. The purpose of this study was to evaluate volume and contour differences between orbital cavities in healthy humans.

Materials And Methods: In this cross-sectional study, the left and right orbital cavities of a consecutive sample of patients' computed tomograms were measured.

How reliable is the visual appraisal of a surgeon for diagnosing orbital fractures?

Purpose: The aim of this study was to evaluate the usefulness of intra-operative visualisation, endoscopic assistance, and CT measurements for estimating the orbital fracture size and complexity.

Methods: Ten human cadaver heads were subjected to thin-slice computed tomography (CT). Standardised fractures were created using piezoelectric surgery in accordance with the Jaquiéry classification system.

Predictability in orbital reconstruction: A human cadaver study. Part II: Navigation-assisted orbital reconstruction.

Preformed orbital reconstruction plates are useful for treating orbital defects. However, intraoperative errors can lead to misplaced implants and poor outcomes. Navigation-assisted surgery may help optimize orbital reconstruction.

Predictability in orbital reconstruction. A human cadaver study, part III: Implant-oriented navigation for optimized reconstruction.

Navigation-assisted orbital reconstruction remains a challenge, because the surgeon focuses on a two-dimensional multiplanar view in relation to the preoperative planning. This study explored the addition of navigation markers in the implant design for three-dimensional (3D) orientation of the actual implant position relative to the preoperative planning for more fail-safe and consistent results. Pre-injury computed tomography (CT) was performed for 10 orbits in human cadavers, and complex orbital fractures (Class III/IV) were created.

Predictability in orbital reconstruction: A human cadaver study. Part I: Endoscopic-assisted orbital reconstruction.

In the treatment of orbital defects, surgeon errors may lead to incorrect positioning of orbital implants and, consequently, poor clinical outcomes. Endoscopy can provide additional visualization of the orbit through the transantral approach. We aimed to evaluate whether endoscopic guidance during orbital reconstruction facilitates optimal implant placement and can serve as a convenient alternative for navigation and intra-operative imaging.

Orbital volume analysis: validation of a semi-automatic software segmentation method.

Purpose: The purpose of this study was to validate a quick, accurate and reproducible (semi-) automatic software segmentation method to measure orbital volume in the unaffected bony orbit. Precise volume measurement of the orbital cavity is a useful addition to pre-operative planning and intraoperative navigation in orbital reconstruction.

Methods: In 21 CT scans, one unaffected orbit was selected to compare manual segmentation (gold standard) with three segmentation methods using iPlan software (version 3.