Individual Design and Rapid Prototyping in Reconstruction of Orbital Wall Defects

Purpose: We examined the application of individual digital design and rapid prototyping in the reconstruction of orbital wall defects for different stages of orbital volume (OV) changes. Patients and Methods: Patients with unilateral post-traumatic orbital defects underwent individual digital design and rapid prototyping to manufacture specific titanium mesh implants to create ideal OV recovery. Features of orbital wall fracture deformities and OV changes were analyzed and measured with 3-Dimensional Medical Surface Rendering image software system. Results: Most cases involving enophthalmos and diplopia were rectified, except for 5 cases of enophthalmos and 2 cases of diplopia with fresh fractures and 11 cases of enophthalmos and 7 cases of diplopia cases with old fractures. Ocular movements and facial malformations were improved. The OV values between the uninjured and injured sides had a significant deviation (P < .05). The degree of enophthalmos had no significant deviation with OV changes pre- and postoperatively in the early fracture stages. The degree of enophthalmos in the old fracture stages had a significant deviation with OV changes pre- and postoperatively. Conclusions: This study showed that orbital wall fractures can be diagnosed in early fracture stages and that the degree of long-term enophthalmos can be predicted with 3-Dimensional Medical Surface Rendering software. Our results suggest that early-stage orbital wall fractures should recover OV as early as possible, and that advanced stage orbital wall fractures should overcorrect OV. The degree of accuracy and rational of OV reconstruction can be improved by appropriate individual digitalization design and rapid prototyping technology. (C) 2010 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 68:562-570, 2010