Surgical precision and clinical outcomes of 3D preformed titanium mesh in orbital blowout fracture reconstruction: a comparative study from Thailand.

Abstract

Background: Orbital floor fractures are frequently associated with head trauma, and the complex three-dimensional (3D) structure of the orbital cavity poses a significant challenge for accurate repair of orbital wall defects. Accordingly, this study aimed to compare preoperative titanium mesh bending using 3D-printed models with conventional intraoperative bending techniques, focusing on the accuracy of orbital geometry reconstruction and intraoperative efficiency, with the goal of determining potential advantages in optimizing surgical outcomes.

Methods: This study presents a comparative analysis between a prospective preoperative bending (3D pre-bent) of titanium mesh and retrospective data from conventional intraoperative bending. Clinical and radiographic evaluations of orbital geometry, along with intraoperative efficiency metrics, were assessed at both preoperative and postoperative stages.

Results: Sixty-four patients were included, with 32 in the 3D pre-bend titanium mesh group and 32 in the conventional bending group. Mean operative time was shorter in the 3D pre-bend group (81.07± 13.04 minutes) than in the conventional group (96.07± 4.46 minutes). The 3D pre-bend group achieved more accurate reconstruction, with orbital volume and height correction rates of 96.78% ± 4.91% and 100.62%± 3.77%, respectively, versus 94.88% ± 4.33% and 96.08% ± 5.44% in the conventional group. Patient and surgeon satisfaction was higher in the 3D pre-bend group.

Conclusion: Pre-bending titanium mesh using a 3D-printed model significantly reduces intraoperative time and improves orbital height correction. Additionally, this technique enhances both patient and surgeon satisfaction. However, long-term clinical outcomes remain comparable between groups.