3D Printing Technique Assisted Individualized Reconstruction Surgery Of Blowout Orbital Fracture

Objective:The purpose of this study was to explore the value of 3D printing technique-assisted individualized surgery in the reconstruction of blowout orbital fracture. Methods:The clinical data was retrospectively analyzed in the patients who accepted surgical reconstruction of blowout orbital fracture in the second hospital of Jilin University from May 2014 to July 2015. The data includes a total of 56 cases(56 eyes). According to whether using 3D printing technology assisted surgery, the patients were divided into A and B groups. A group covers patients accepted traditional surgery without using 3D technique, but B group covers patients who undertook orbital reconstruction surgery assisted with 3D printing technique. As for 3D printing technique-assisted reconstruction surgery, a 3D orbital model is first constructed from patient’s CT images with MIMICS software and printed out by using a 3D printer, and then a simulated artificial bone model is produced according to the fracture zone before operation. During operation, Medpor-Titanium implant is trimmed according to the contour of simulated bone model and then implanted into patient’s orbit covering the fracture area. To assess the value of 3D technique in orbital reconstruction surgery, the CT images from A and B groups were statistically analyzed and measured after operation and the duration of operation was compared as well. Results:1. In the two groups, the difference between the maximum depth of fracture and the maximum depth of implants of each patient was compared and analyzed. The difference of B group is significantly smaller than that of A group(P<0.05). Meanwhile, the difference between the maximum width of fracture and maximum width of implants in the two groups was compared. The difference of B group is significantly smaller than that of A group(P<0.05).2. The difference between the average depth of fracture and average depth of implants in the two groups was compared. The difference of B group is significantly smaller than that of A group(P<0.05). The difference between the average width of fracture and average width of implants in the two groups was compared. The difference of B group is significantly smaller than that of A group(P<0.05).3. Angle difference of orbital medial and inferior corner in the same coronal plane between the surgical eye after surgery and the healthy eye was compared. The difference of B group is significantly smaller than that of A group(P<0.05).4. The difference between the distance between the optic nerve canal and the depth of the fracture and the distance between the optic nerve canal and the depth of the implant was compared. The difference of A group is significantly smaller than that of B group(P<0.05).5. The duration of surgery in B group is significantly shorter than that in group A(P<0.05). Especially for the reconstruction both orbital medial and inferior walls fracture, surgery duration in B group is significantly shorter than that in group A(P<0.05). Conclusion:3D printing technique is of important value in predicting the precise fracture zone and angle before and during individualized surgery, which facilities operator to achieve the goal of anatomical reconstruction for blowout orbital fracture. Moreover, the simulated bone model makes Medpor-Titanium implant fit the contour of fractured walls better, which greatly saves surgery time. Thereby, 3D printing technique improves surgery process and reduces the secondary injury and complications during and after operation. 3D printing technique is an advanced approach to realize the precise and individualized reconstruction of blowout orbital fracture.