Artikel
„Real-time rapid manufacturing“ in computer-optimized surgical orbita recon-struction
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Autoren
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Joerg Schipper
- Universitäts-HNO-Klinik, Freiburg
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Wolfgang Maier
- Universitäts-HNO-Klinik, Freiburg
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Wolf Lagrèze
- Universitäts-Augen-Klinik, Freiburg
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Nils-Claudius Gellrich
- Klinik für MKG, Medizinische Hochschule, Hannover
| Veröffentlicht: | 22. September 2005 |
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Gliederung
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Aim: Normally, modifications of the bony orbita borders by trauma or tumour lead to a shift of the visual axis, perceived as double images by the patient. Re-parallelizing of the visual axis requires a precise surgical procedure. Computer assisted surgery (CAS) allows precision within millimeters.
Method: In preoperative lateral comparison CAS can help calculate the missing or redundant volume of the modified bony orbita and help define the necessary form, size and position of required transplants or implants. Morphometrical and neuro-ophthalmological parameters influence the geometry of the face that has to be re-constructed. „Real-time rapid manufacturing“ (RTRM) is a navigation-controlled procedure, the required transplants or implants being produced and positioned in-traoperatively; they are made from split bone grafts from the external tabula of the cranial bones or from titan mesh plates.
Results: The „real-time rapid manufacturing“ procedure is exemplarily presented with 5 patients of different etiologies. For quality control, all patients received a thorough neuroophthalmological examination postoperatively, and a 3D computed tomography was performed in comparison to the preoperative 3D CT scan. In all patients the pa-thologically modified visual axis could be reparallelized.
Conclusion: RTRM allows cosmetical and functional reconstruction of the visual axis.
