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Application of Three-Dimensional Printing Technology in the Orbital Blowout Fracture Reconstruction

Zhang, Xiang MM*; Chen, Wei MD; Luo, Ting-Yuan MM; Ma, Juan MM*; Dong, Zhen MM; Cao, Gang MD; Xu, Jin-ke MM; Liu, Bin-Yao MM; Zhang, Qi-Rui MM§; Zhang, Sen-Lin MD

doi: 10.1097/SCS.0000000000005574
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The aim of this study was to investigate the clinical outcomes of orbital blowout fracture repair by using the three-dimensional (3D) printing-assisted fabrication of individual titanium mesh. Clinical and radiologic data were analyzed for 12 patients with orbital floor and/or medial wall fractures. Lower eyelid incision was used to expose the fractures. Preoperative computed tomographic data were input into an imaging software to rebuild a 3D orbit and mirror the unaffected side into the affected side to replace the demolished orbit. A resin model of the reshaped orbit was generated and used to develop an individual titanium mesh for repairing the fractured orbital. The surgical results were assessed by value of enophthalmos and a comparison of preoperative and postoperative orbital volume difference. All patients had a successful treatment outcome without any complications. Clinical significant enophthalmos were not observed after treatment, and diplopia were solved within 2 weeks postoperative. No extraocular muscle limitation was observed. Postoperative computed tomography scans demonstrated appropriate positioning of titanium mesh and there was no implant displacement. The postoperative orbital volume and enophthalmos difference between the 2 eyes decreased significantly than preoperative (P < 0.001). Three-dimensional printing-assisted fabrication of individual titanium mesh is appropriate for use in orbital blowout fracture.

*The Affiliated Stomatological Hospital of Soochow University, Suzhou, Jiangsu

Department of Stomatology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing

Huizhou Stomatological Hospital, Jinan University, Huizhou

§Department of Medical Imaging, Jinling Hospital, Nanjing College of Clinical Medicine, Southern Medical University, Nanjing, China.

Address correspondence and reprint requests to Wei Chen, MD and Sen-Lin Zhang, MD, Department of Stomatology, Jinling Hospital, School of Medicine, Nanjing University, 305 East Zhongshan Road, Nanjing 210002, Jiangsu, China; E-mail: rollphy@aliyun.com; doczhangsl@gmail.com

Received 3 February, 2019

Accepted 8 March, 2019

XZ, WC, and T-YL equally contributed to this work.

This study was supported by grants from the Project of Invigorating Health Care through Science, Technology and Education of Jiangsu Province (Grant no. QNRC2016907). This investigation was approved by the Ethics Committee on Human Study at Jinling Hospital (Approved No. 2014-135).

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcraniofacialsurgery.com).

© 2019 by Mutaz B. Habal, MD.