Analysis of the Results of Reconstructive and Restorative Operations in Post-Traumatic Orbital Defects by Computer Simulation

Abstract

Treatment of patients with post-traumatic orbital defects is relevant problem of ophthalmology and maxillofacial surgery. Residual diplopia or dislocation of the eyeball leads to disability, social maladaptation and development of psychoemotional disorders in patients. In this paper, we present an evaluation of treatment of patients with posttraumatic orbital wall defects based on the retrospective comparative analysis of CT data by computer simulation before and after reconstruction. When comparing the volume of the injured orbits before and after the operation (average volume difference was 2.7 ± 0.9 cm3), a significant improvement was found in terms of recovery of the orbital volume. The factors influencing the treatment effectiveness were determined based on the calculation of the volume of the orbits on the healthy and injured side in the software environment before and after the reconstruction. The causes of the detected cases of incomplete recovery of the orbital volume were analyzed. The solution to the problem of restoring the orbital volume is in the plane of restoring the geometry of the orbit because previous adaptation of the shape of the standard plate to its anatomical structure with overlapping defect on the stereolithographic model provided the best end result. Conclusions. Personalized adaptation of the implants to the shape of the orbit or individual production thereof can increase the accuracy of the orbital volume restoration, which can increase the effectiveness of eliminating complications such as enophthalmos and diplopia. The effectiveness of treatment of post-traumatic orbital defects by traditional methods directly depends on the severity of the damage, the degree of which determines the magnitude of the change in the orbital volume. However, the greater is the volume of the orbit changes as a result of the injury, the worse is the prognosis for its recovery. Development of the ways to individualize implants and evaluate their effectiveness is an important area for further research. Keywords: post-traumatic orbital defects, reconstructive surgery, computer simulation.