Τίτλος:
Enophthalmos correction in complex orbital floor reconstruction. Computer-assisted, intraoperative, non-contact, optical 3D support [Enophthalmuskorrektur bei komplexer orbitarekonstruktion. Computerassistierte, intraoperative, berührungsfreie, optische 3D-unterstützung]
Περίληψη:
In the case of displacement of the globe such as enophthalmos induced by trauma, the patient is affected on both counts: function and aesthetics. To prevent double vision or conspicuous asymmetry, exact correction of the globe position is required. The aim of this case report is to demonstrate an intraoperative computer-assisted, non-contact, optical 3D procedure for identification of the globe position to aid in placing the eyeball in the position required in complex reconstruction of the orbital floor. A 33-year-old man presented with a sunken eye on the right side in the horizontal and vertical plane 6 months after having undergone surgery elsewhere for a zygomatico-orbital fracture, also including the orbital floor. The patient was affected by double vision and a noticeable defective globe position. In planning the correction of the globe position, a three-dimensional image of the face with opened eyes was made with the optical sensor. Automatic comparison of symmetry revealed enophthalmos of 4 mm on relative en- and exophthalmometry. The decision was made to lift the orbital floor with a split calvarial bone graft. During surgery the position of the globe was also controlled by the three-dimensional optical technique. At the end of surgery there was exophthalmos of 1 mm. Six weeks after surgery the patient was not affected by any double vision. After 3 and 24 months enophthalmos was 1 mm. This case demonstrates how the non-ionizing, non-contact, optical 3D technique can help in planning, intraoperative transformation, and clinical monitoring to identify the correct position of the corneal vertex in complex orbital floor reconstruction. © 2007 Springer Medizin Verlag.
Συγγραφείς:
Kühnel, T.V.
Vairaktaris, E.
Schlegel, K.A.
Neukam, F.W.
Kühnel, B.
Holbach, L.M.
Nkenke, E.
Περιοδικό:
Ophthalmology Glaucoma
Λέξεις-κλειδιά:
adult; article; case report; computer assisted surgery; computer assisted tomography; computer interface; diagnostic imaging; diplopia; enophthalmos; face injury; human; image processing; injury; male; methodology; orbit; osteosynthesis; postoperative complication; skiing; three dimensional imaging; visual system examination; zygoma arch fracture, Adult; Diagnostic Imaging; Diagnostic Techniques, Ophthalmological; Diplopia; Enophthalmos; Facial Injuries; Fracture Fixation, Internal; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Male; Orbit; Postoperative Complications; Skiing; Surgery, Computer-Assisted; Tomography, X-Ray Computed; User-Computer Interface; Zygomatic Fractures
DOI:
10.1007/s00347-007-1585-y
