TY - JOUR
T1 - Surgical instrument to improve implant positioning in orbital reconstruction
T2 - a feasibility study
AU - Schreurs, R.
AU - Dubois, L.
AU - Klop, C.
AU - Beenen, L. F.M.
AU - Habets, P. E.M.H.
AU - Maal, T. J.J.
AU - Becking, A. G.
N1 - Funding Information: This research was supported by the SORG Research Grant Award 2017 (Strasbourg Osteosynthesis Research Group). KLS Martin provided in kind support of the orbital implants used and the titanium fixation screws. The titanium coupling device of the instrument was fabricated by KLS Martin and provided in kind as well. Publisher Copyright: © 2021 The Authors
PY - 2021/9
Y1 - 2021/9
N2 - Adequate positioning of an orbital implant during orbital reconstruction surgery is essential for restoration of the pre-traumatised anatomy, but visual appraisal of its position is limited by the keyhole access and protruding soft tissues. A positioning instrument that attaches to the implant was designed to provide feedback outside the orbit. The goal of this study was to evaluate the accuracy of placement with the instrument and compare it with the accuracy of placement by visual appraisal. Ten orbits in five human cadaver heads were reconstructed twice: once using visual appraisal and once using the instrument workflow. No significant improvement was found for the roll (5.8° vs 3.4°, respectively, p=0.16), pitch (2.1° vs 1.5°, p=0.56), or translation (2.9 mm vs 3.3 mm, p=0.77), but the yaw was significantly reduced if the instrument workflow was used (15.3° vs 2.9°, p=0.02). The workflow is associated with low costs and low logistical demands, and may prevent outliers in implant positioning in a clinical setting when intraoperative navigation or patient-specific implants are not available.
AB - Adequate positioning of an orbital implant during orbital reconstruction surgery is essential for restoration of the pre-traumatised anatomy, but visual appraisal of its position is limited by the keyhole access and protruding soft tissues. A positioning instrument that attaches to the implant was designed to provide feedback outside the orbit. The goal of this study was to evaluate the accuracy of placement with the instrument and compare it with the accuracy of placement by visual appraisal. Ten orbits in five human cadaver heads were reconstructed twice: once using visual appraisal and once using the instrument workflow. No significant improvement was found for the roll (5.8° vs 3.4°, respectively, p=0.16), pitch (2.1° vs 1.5°, p=0.56), or translation (2.9 mm vs 3.3 mm, p=0.77), but the yaw was significantly reduced if the instrument workflow was used (15.3° vs 2.9°, p=0.02). The workflow is associated with low costs and low logistical demands, and may prevent outliers in implant positioning in a clinical setting when intraoperative navigation or patient-specific implants are not available.
KW - instrument
KW - instrument design
KW - orbit
KW - orbital reconstruction
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U2 - https://doi.org/10.1016/j.bjoms.2021.02.023
DO - https://doi.org/10.1016/j.bjoms.2021.02.023
M3 - Article
C2 - 34256960
SN - 0266-4356
VL - 59
SP - 826
EP - 830
JO - British Journal of Oral and Maxillofacial Surgery
JF - British Journal of Oral and Maxillofacial Surgery
IS - 7
ER -