PDF(Pubmed)
Abstract：
BACKGROUND: Orbital floor fractures (OFFs) represent an interesting chapter in maxillofacial surgery, and one of the main challenges in orbit reconstruction is shaping and cutting the precise contour of the implants due to its complex anatomy.
OBJECTIVE: The aim of the retrospective study was to demonstrate, through pre- and postoperative volumetric measurements of the orbit, how the use of a preformed titanium mesh based on the stereolithographic model produced with 3D printers (\"In-House\" reconstruction) provides a better reconstruction volumetric compared to the intraoperatively shaped titanium mesh.
METHODS: The patients with OFF enrolled in this study were divided into two groups according to the inclusion criteria. In Group 1 (G1), patients surgically treated for OFF were divided into two subgroups: G1a, patients undergoing orbital floor reconstruction with an intraoperatively shaped mesh, and G1b, patients undergoing orbital floor reconstruction with a preoperative mesh shaped on a 3D-printed stereolithographic model. Group 2 (G2) consisted of patients treated for other traumatic pathologies (mandible fractures and middle face fractures not involving orbit). Pre- and postoperative orbital volumetric measurements were performed on both G1 and G2. The patients of both groups were subjected to the measurement of orbital volume using Osirix software (Pixmeo SARL, CH-1233 Bernex, Switzerland) on the new CT examination. Both descriptive (using central tendency indices such as mean and range) and regressive (using the Bravais-Pearson index, calculated using the GraphPad program) statistical analyses were performed on the recorded data.
RESULTS: From 1 January 2017 to 31 December 2021, of the 176 patients treated for OFF at the \"Magna Graecia\" University Hospital of Catanzaro 10 fulfilled the study\'s inclusion criteria: 5 were assigned to G1a and 5 to G1b, with a total of 30 volumetric measurements. In G2, we included 10 patients, with a total of 20 volumetric measurements. From the volumetric measurements and statistical analysis carried out, it emerged that the average of the volumetric differences of the healthy orbits was ±0.6351 cm3, the standard deviation of the volumetric differences was ±0.3383, and the relationship between the treated orbit and the healthy orbit was linear; therefore, the treated orbital volumes tend to approach the healthy ones after surgical treatment.
CONCLUSIONS: This study demonstrates that if the volume is restored within the range of the standardized mean, the diplopia is completely recovered already after surgery or after one month. For orbital volumes that do not fall within this range, functional recovery could occur within 6 months or be lacking. The restoration of the orbital volume using pre-modeled networks on the patient\'s anatomical model, printed internally in 3D, allows for more accurate reconstructions of the orbital floor in less time, with clinical advantages also in terms of surgical timing.
OBJECTIVE: The aim of the retrospective study was to demonstrate, through pre- and postoperative volumetric measurements of the orbit, how the use of a preformed titanium mesh based on the stereolithographic model produced with 3D printers (\"In-House\" reconstruction) provides a better reconstruction volumetric compared to the intraoperatively shaped titanium mesh.
METHODS: The patients with OFF enrolled in this study were divided into two groups according to the inclusion criteria. In Group 1 (G1), patients surgically treated for OFF were divided into two subgroups: G1a, patients undergoing orbital floor reconstruction with an intraoperatively shaped mesh, and G1b, patients undergoing orbital floor reconstruction with a preoperative mesh shaped on a 3D-printed stereolithographic model. Group 2 (G2) consisted of patients treated for other traumatic pathologies (mandible fractures and middle face fractures not involving orbit). Pre- and postoperative orbital volumetric measurements were performed on both G1 and G2. The patients of both groups were subjected to the measurement of orbital volume using Osirix software (Pixmeo SARL, CH-1233 Bernex, Switzerland) on the new CT examination. Both descriptive (using central tendency indices such as mean and range) and regressive (using the Bravais-Pearson index, calculated using the GraphPad program) statistical analyses were performed on the recorded data.
RESULTS: From 1 January 2017 to 31 December 2021, of the 176 patients treated for OFF at the \"Magna Graecia\" University Hospital of Catanzaro 10 fulfilled the study\'s inclusion criteria: 5 were assigned to G1a and 5 to G1b, with a total of 30 volumetric measurements. In G2, we included 10 patients, with a total of 20 volumetric measurements. From the volumetric measurements and statistical analysis carried out, it emerged that the average of the volumetric differences of the healthy orbits was ±0.6351 cm3, the standard deviation of the volumetric differences was ±0.3383, and the relationship between the treated orbit and the healthy orbit was linear; therefore, the treated orbital volumes tend to approach the healthy ones after surgical treatment.
CONCLUSIONS: This study demonstrates that if the volume is restored within the range of the standardized mean, the diplopia is completely recovered already after surgery or after one month. For orbital volumes that do not fall within this range, functional recovery could occur within 6 months or be lacking. The restoration of the orbital volume using pre-modeled networks on the patient\'s anatomical model, printed internally in 3D, allows for more accurate reconstructions of the orbital floor in less time, with clinical advantages also in terms of surgical timing.
摘要：
背景：眶底骨折（OFFs）代表了颌面外科的一个有趣的章节，在轨道重建的主要挑战之一是塑造和切割精确轮廓的植入物，由于其复杂的解剖结构。
目的：回顾性研究的目的是证明，通过眼眶的前后体积测量，与手术中成形的钛网相比，如何使用基于3D打印机产生的立体光刻模型的预制钛网（“内部重建”）提供更好的体积重建。
方法：将纳入本研究的OFF患者按照纳入标准分为两组。在第1组（G1）中，手术治疗的患者分为两个亚组：G1a，使用术中形状的网状物进行眶底重建的患者，G1b,使用3D打印立体光刻模型上成形的术前网格进行眶底重建的患者。第2组（G2）包括接受其他创伤性病变（下颌骨骨折和不涉及眼眶的中部面部骨折）治疗的患者。对G1和G2进行术前和术后眼眶容积测量。两组患者均使用Osirix软件（PixmeoSARL，CH-1233Bernex,瑞士）关于新的CT检查。既是描述性的(使用均值和范围等集中趋势指数)，也是回归性的(使用布拉瓦斯-皮尔逊指数，使用GraphPad程序计算）对记录的数据进行统计分析。
结果：从2017年1月1日至2021年12月31日，在卡坦扎罗大学医院接受OFF治疗的176例患者中，卡坦扎罗大学医院10符合研究的纳入标准：5例被分配到G1a，5例被分配到G1b，共有30个体积测量。在G2中，我们包括10名患者，共有20个体积测量。根据体积测量和统计分析，结果发现，健康轨道的体积差异的平均值为±0.6351cm3，体积差异的标准偏差为±0.3383，治疗轨道与健康轨道之间的关系是线性的；因此，手术治疗后，治疗后的眼眶体积倾向于接近健康眼眶。
结论：这项研究表明，如果体积在标准化平均值范围内恢复，手术后或一个月后复视已完全恢复。对于不在此范围内的轨道体积，功能恢复可能在6个月内发生或缺乏。在患者的解剖模型上使用预先建模的网络恢复眼眶体积，内部3D打印,允许在更短的时间内更准确地重建轨道地板，在手术时机方面也具有临床优势。
目的：回顾性研究的目的是证明，通过眼眶的前后体积测量，与手术中成形的钛网相比，如何使用基于3D打印机产生的立体光刻模型的预制钛网（“内部重建”）提供更好的体积重建。
方法：将纳入本研究的OFF患者按照纳入标准分为两组。在第1组（G1）中，手术治疗的患者分为两个亚组：G1a，使用术中形状的网状物进行眶底重建的患者，G1b,使用3D打印立体光刻模型上成形的术前网格进行眶底重建的患者。第2组（G2）包括接受其他创伤性病变（下颌骨骨折和不涉及眼眶的中部面部骨折）治疗的患者。对G1和G2进行术前和术后眼眶容积测量。两组患者均使用Osirix软件（PixmeoSARL，CH-1233Bernex,瑞士）关于新的CT检查。既是描述性的(使用均值和范围等集中趋势指数)，也是回归性的(使用布拉瓦斯-皮尔逊指数，使用GraphPad程序计算）对记录的数据进行统计分析。
结果：从2017年1月1日至2021年12月31日，在卡坦扎罗大学医院接受OFF治疗的176例患者中，卡坦扎罗大学医院10符合研究的纳入标准：5例被分配到G1a，5例被分配到G1b，共有30个体积测量。在G2中，我们包括10名患者，共有20个体积测量。根据体积测量和统计分析，结果发现，健康轨道的体积差异的平均值为±0.6351cm3，体积差异的标准偏差为±0.3383，治疗轨道与健康轨道之间的关系是线性的；因此，手术治疗后，治疗后的眼眶体积倾向于接近健康眼眶。
结论：这项研究表明，如果体积在标准化平均值范围内恢复，手术后或一个月后复视已完全恢复。对于不在此范围内的轨道体积，功能恢复可能在6个月内发生或缺乏。在患者的解剖模型上使用预先建模的网络恢复眼眶体积，内部3D打印,允许在更短的时间内更准确地重建轨道地板，在手术时机方面也具有临床优势。
