Semiautomatic procedure for individual preforming of titanium meshes for orbital fractures.

Background: Three-dimensional reconstruction of the orbital floor is a key procedure in primary or secondary orbital deformity. A new procedure for individually bending and preforming implants preoperatively for the reconstruction of orbital fractures is presented.

Methods: By using diagnostic computed tomographic scan data, the topography of the orbital floor and wall structures can be recalculated. After mirroring the unaffected side onto the affected side, the defect can be reconstructed virtually. Data of the individual virtual model of the orbital cavity are sent to a template machine that reproduces the surface of the orbital floor and medial walls automatically. A titanium mesh can then be adjusted preoperatively for exact three-dimensional reconstruction. Twelve patients with orbital fractures were treated using individually preformed titanium implants.

Results: All patients treated with this procedure showed normal eye mobility and function after primary reconstruction. The accuracy of the preformed implants lies in the range of 1 mm.

Conclusions: This procedure offers an individual anatomical reconstruction of the orbital cavity true to original, especially when the deep orbital cone is affected. Navigation-aided procedures guarantee intraoperatively an exact placement of the preformed mesh even for precise reconstruction of extensive orbital defects.