Patient-Specific Implant Customization for Treatment of Internal Orbital Fractures Using Office-Based Three-Dimensional Printing

Authors

Joshua S. Yoon, Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD.
Manaahil Rao, Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD.
Ryan Dunlow, Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD.
Philip Wasicek, Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD.
Michael Ha, Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.
Paulina Le, Division of Plastic and Reconstructive Surgery, School of Medicine, Prisma Health/University of South Carolina, Columbia, SC.
Yvonne M. Rasko, Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.
Fan Liang, Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD.
Michael P. Grant, Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD.
Arthur J. Nam, Division of Plastic and Reconstructive Surgery, School of Medicine, Prisma Health/University of South Carolina, Columbia, SC.

Document Type

Journal Article

Publication Date

2-6-2024

Journal

The Journal of craniofacial surgery

DOI

10.1097/SCS.0000000000009941

Abstract

OBJECTIVE: Three-dimensional (3D) modeling technology aids the reconstructive surgeon in designing and tailoring individualized implants for the reconstruction of complex craniofacial fractures. Three-dimensional modeling and printing have traditionally been outsourced to commercial vendors but can now be incorporated into both private and academic craniomaxillofacial practices. The goal of this report is to present a low-cost, standardized office-based workflow for restoring bony orbital volume in traumatic orbital fractures. METHODS: Patients with internal orbital fractures requiring open repair were identified. After the virtual 3D models were created by iPlan 3.0 Cranial CMF software (Brainlab), the models were printed using an office-based 3D printer to shape and modify orbital plates to correctly fit the fracture defect. The accuracy of the anatomic reduction and the restored bony orbital volume measurements were determined using postoperative computed tomography images and iPlan software. RESULTS: Nine patients fulfilled the inclusion criteria: 8 patients had unilateral fractures and 1 patient had bilateral fractures. Average image processing and print time were 1.5 hours and 3 hours, respectively. The cost of the 3D printer was $2500 and the average material cost to print a single orbital model was $2. When compared with the uninjured side, the mean preoperative orbital volume increase and percent difference were 2.7 ± 1.3 mL and 10.9 ± 5.3%, respectively. Postoperative absolute volume and percent volume difference between the orbits were -0.2 ± 0.4 mL and -0.8 ± 1.7%, respectively. CONCLUSIONS: Office-based 3D printing can be routinely used in the repair of internal orbital fractures in an efficient and cost-effective manner to design the implant with satisfactory patient outcomes.

APA Citation

Yoon, Joshua S.; Rao, Manaahil; Dunlow, Ryan; Wasicek, Philip; Ha, Michael; Le, Paulina; Rasko, Yvonne M.; Liang, Fan; Grant, Michael P.; and Nam, Arthur J., "Patient-Specific Implant Customization for Treatment of Internal Orbital Fractures Using Office-Based Three-Dimensional Printing" (2024). GW Authored Works. Paper 4379.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4379

Department

School of Medicine and Health Sciences Resident Works