Application of Computer-Aided Designing and Rapid Prototyping Technologies in Reconstruction of Blowout Fractures of the Orbital Floor.

INTRODUCTION: Traumatology of the maxillofacial region represents a wide range of different types of facial skeletal injuries and encompasses numerous treatment methods. Application of computer-aided design (CAD) in combination with rapid prototyping (RP) technologies and three-dimensional computed tomography techniques facilitates surgical therapy planning for efficient treatment.

OBJECTIVE: The purpose of this study is to determine the efficiency of individually designed implants of poly-DL-lactide (PDLLA) in the reconstruction of blowout fractures of the orbital floor.

METHODS: In the course of a surgical treatment, individually designed implants manufactured by CAD/RP technologies were used. Preoperative analysis and postoperative monitoring were conducted to evaluate the successfulness of orbital floor reconstruction using customized PDLLA implants, based on: presence of diplopia, paresthesia of infraorbital nerve, and presence of enophthalmos.

RESULTS: In 6 of the 10 patients, diplopia completely disappeared immediately after surgical procedure. Diplopia gradually disappeared after 1 month in 3 patients, whereas in 1, it remained even after 6 months. In 7 patients, paresthesia disappeared within a month after surgery and in 3 patients within 2 months. Postoperative average Orbital volume (OV) of the injured side (13.333 ± 3.177) was significantly reduced in comparison with preoperative OV (15.847 ± 3.361) after reconstruction of the orbital floor with customized PDLLA implant (P < 0.001). Thus, average OV of corrected orbit was not different compared with the OV of the uninjured orbit (P = 0.981).

CONCLUSIONS: Reconstruction of blowout fractures of the orbital floor by an individually designed PDLLA implant combined with virtual preoperative modeling allows easier preoperative preparation and yields satisfactory functional and esthetic outcomes.