Objectives:

To assess reconstruction with preformed orbital titanium meshes in our patients. To evaluate the influence of surgical planning and intraoperative navigation in orbital reconstruction accuracy.

Material and method:

Patients with unilateral orbital floor fractures reconstructed with preformed titanium meshes between 2009 and 2014 were included. Computed tomographies (CT) were analyzed with iPlan 3.0 (BrainLab). Orbital mesh was imported as a Standard Tesellation Language (STL) object and it was placed in the best position over the mirror uninjured orbit. Difference of volume between healthy and reconstructed orbits (VD) and variables to measure contour adaptation of the orbital mesh were evaluated. Intraoperative navigation was done with the BrainLab Kolibrí navigation system.

Results:

A total of 17 patients were reconstructed, 10 with preoperative planning and intraoperative navigation. VD was statistically lower in the group that was reconstructed using navigation (0.24 ± 0.13cc), P < .01. In 9 patients the position of the mesh was not adequate in the preoperative CT: the mesh protruded 1.88 ± 0.27 mm below the infraorbital rim, and 3.23 ± 1.3 mm in the nose with an angle of 13 ± 5.2°. Postoperative adaptation was statistically better in navigated patients (P < .05).

Conclusions:

Preformed orbital meshes needed adjustments in about 50% of our patients. Preoperative planning and surgical navigation help identifying them, increasing accuracy in their reconstructions.

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