Accuracy of free-hand positioned patient specific implants (PSI) in primary reconstruction after inferior and/or medial orbital wall fractures

2021 ◽  
Vol 137 ◽  
pp. 104791
Author(s):  
Florian Andreas Probst ◽  
Carl-Peter Cornelius ◽  
Sven Otto ◽  
Yoana Malenova ◽  
Monika Probst ◽  
...  
Keyword(s):  
Patient Specific ◽  
Primary Reconstruction ◽  
Patient Specific Implants ◽  
Orbital Wall ◽  
Medial Orbital Wall

Rapid prototyped patient specific implants for reconstruction of orbital wall defects

2014 ◽  
Vol 42 (8) ◽  
pp. 1644-1649 ◽  
Author(s):  
Patricia Stoor ◽  
Anni Suomalainen ◽  
Christian Lindqvist ◽  
Karri Mesimäki ◽  
Daniel Danielsson ◽  
...  
Keyword(s):  
Patient Specific ◽  
Patient Specific Implants ◽  
Orbital Wall

scholarly journals A Multi-Criteria Assessment Strategy for 3D Printed Porous Polyetheretherketone (PEEK) Patient-Specific Implants for Orbital Wall Reconstruction

2021 ◽  
Vol 10 (16) ◽  
pp. 3563
Author(s):  
Neha Sharma ◽  
Dennis Welker ◽  
Soheila Aghlmandi ◽  
Michaela Maintz ◽  
Hans-Florian Zeilhofer ◽  
...  
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Patient Specific ◽  
Fused Filament Fabrication ◽  
Decision Matrix ◽  
Maximum Deformation ◽  
Patient Specific Implants ◽  
High Durability ◽  
Orbital Wall ◽  
3D Printed

Pure orbital blowout fractures occur within the confines of the internal orbital wall. Restoration of orbital form and volume is paramount to prevent functional and esthetic impairment. The anatomical peculiarity of the orbit has encouraged surgeons to develop implants with customized features to restore its architecture. This has resulted in worldwide clinical demand for patient-specific implants (PSIs) designed to fit precisely in the patient’s unique anatomy. Material extrusion or Fused filament fabrication (FFF) three-dimensional (3D) printing technology has enabled the fabrication of implant-grade polymers such as Polyetheretherketone (PEEK), paving the way for a more sophisticated generation of biomaterials. This study evaluates the FFF 3D printed PEEK orbital mesh customized implants with a metric considering the relevant design, biomechanical, and morphological parameters. The performance of the implants is studied as a function of varying thicknesses and porous design constructs through a finite element (FE) based computational model and a decision matrix based statistical approach. The maximum stress values achieved in our results predict the high durability of the implants, and the maximum deformation values were under one-tenth of a millimeter (mm) domain in all the implant profile configurations. The circular patterned implant (0.9 mm) had the best performance score. The study demonstrates that compounding multi-design computational analysis with 3D printing can be beneficial for the optimal restoration of the orbital floor.

scholarly journals A Multi-Criteria Assessment Strategy for 3d Printed Porous Polyetheretherketone (Peek) Patient-Specific Implants for Orbital Wall Reconstruction

2021 ◽  
Author(s):  
Neha Sharma ◽  
Dennis Welker ◽  
Soheila Aghlmandi ◽  
Michaela Maintz ◽  
Hans-Florian Zeilhofer ◽  
...  
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Patient Specific ◽  
Fused Filament Fabrication ◽  
Decision Matrix ◽  
Maximum Deformation ◽  
Patient Specific Implants ◽  
High Durability ◽  
Orbital Wall ◽  
3D Printed

Pure orbital blowout fractures occur within the confines of the internal orbital wall. Restoration of orbital form and volume is paramount to prevent functional and esthetic impairment. The anatomical peculiarity of the orbit has encouraged surgeons to develop implants with customized features to restore its architecture. This has resulted in worldwide clinical demand for patient-specific implants (PSIs) designed to fit precisely in the patient's unique anatomy. Fused filament fabrication (FFF) three-dimensional (3D) printing technology has enabled the fabrication of implant-grade polymers such as Polyetheretherketone (PEEK), paving the way for a more sophisticated generation of biomaterials. This study evaluates the FFF 3D printed PEEK orbital mesh customized implants with a metric considering the relevant design, biomechanical, and morphological parameters. The performance of the implants is studied as a function of varying thicknesses and porous design constructs through a finite element (FE) based computational model and a decision matrix based statistical approach. The maximum stress values achieved in our results predict the high durability of the implants, and the maximum deformation values were under one-tenth of a millimeter (mm) domain in all the implant profile configurations. The circular patterned implant (0.9 mm) had the best performance score. The study demonstrates that compounding multi-design computational analysis with 3D printing can be beneficial for the optimal restoration of the orbital floor.

scholarly journals Intraosseous Venous Malformation of the Zygomatic Bone: Comparison between Virtual Surgical Planning and Standard Surgery with Review of the Literature

2021 ◽  
Vol 10 (19) ◽  
pp. 4565
Author(s):  
Raúl Antúnez-Conde ◽  
Carlos Navarro Cuéllar ◽  
José Ignacio Salmerón Escobar ◽  
Alberto Díez-Montiel ◽  
Ignacio Navarro Cuéllar ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Venous Malformation ◽  
Operation Time ◽  
Patient Specific ◽  
Primary Reconstruction ◽  
Zygomatic Bone ◽  
Virtual Surgical Planning ◽  
Patient Specific Implants ◽  
Cutting Guides ◽  
The Aesthetic

Intraosseous venous malformations affecting the zygomatic bone are infrequent. Primary reconstruction is usually accomplished with calvarial grafts, although the use of virtual surgical planning, cutting guides and patient-specific implants (PSI) have had a major development in recent years. A retrospective study was designed and implemented in patients diagnosed with intraosseous venous malformation during 2006–2021, and a review of the scientific literature was also performed to clarify diagnostic terms. Eight patients were treated, differentiating two groups according to the technique: four patients were treated through standard surgery with resection and primary reconstruction of the defect with calvarial graft, and four patients underwent resection and primary reconstruction through virtual surgical planning (VSP), cutting guides, STL models developed with CAD-CAM technology and PSI (titanium or Polyether-ether-ketone). In the group treated with standard surgery, 75% of the patients developed sequelae or morbidity associated with this technique. The operation time ranged from 175 min to 210 min (average 188.7 min), the length of hospital ranged from 4 days to 6 days (average 4.75 days) and the postoperative CT scan showed a defect surface coverage of 79.75%. The aesthetic results were “excellent” in 25% of the patients, “good” in 50% and “poor” in 25%. In the VSP group, 25% presented sequelae associated with surgical treatment. The operation time ranged from 99 min to 143 min (average 121 min), the length of hospital stay ranged from 1 to 2 days (average of 1.75 days) and 75% of the patients reported “excellent” results. Postoperative CT scan showed 100% coverage of the defect surface in the VSP group. The multi-stage implementation of virtual surgical planning with cutting guides, STL models and patient-specific implants increases the reconstructive accuracy in the treatment of patients diagnosed with intraosseous venous malformation of the zygomatic bone, reducing sequelae, operation time and average hospital stay, providing a better cover of the defect, and improving the precision of the reconstruction and the aesthetic results compared to standard technique.

Resources: Internet Resources for the Independent Medical Evaluator – 2007

2007 ◽  
Vol 12 (4) ◽  
pp. 4-7
Author(s):  
Christopher R. Brigham ◽  
Jenny Walker
Keyword(s):  
Head Trauma ◽  
Clonic Seizure ◽  
Acute Subdural Hematoma ◽  
Orbital Fracture ◽  
Orbital Wall ◽  
First Occurrence ◽  
One Year ◽  
The One ◽  
Neurological Injuries ◽  
Medial Orbital Wall

Abstract Rating patients with head trauma and multiple neurological injuries can be challenging. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, Section 13.2, Criteria for Rating Impairment Due to Central Nervous System Disorders, outlines the process to rate impairment due to head trauma. This article summarizes the case of a 57-year-old male security guard who presents with headache, decreased sensation on the left cheek, loss of sense of smell, and problems with memory, among other symptoms. One year ago the patient was assaulted while on the job: his Glasgow Coma Score was 14; he had left periorbital ecchymosis and a 2.5 cm laceration over the left eyelid; a small right temporoparietal acute subdural hematoma; left inferior and medial orbital wall fractures; and, four hours after admission to the hospital, he experienced a generalized tonic-clonic seizure. This patient's impairment must include the following components: single seizure, orbital fracture, infraorbital neuropathy, anosmia, headache, and memory complaints. The article shows how the ratable impairments are combined using the Combining Impairment Ratings section. Because this patient has not experienced any seizures since the first occurrence, according to the AMA Guides he is not experiencing the “episodic neurological impairments” required for disability. Complex cases such as the one presented here highlight the need to use the criteria and estimates that are located in several sections of the AMA Guides.

Development of JIT patient-specific implants

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Leanne SOBEL ◽  
Katrina SKELLERN ◽  
Kat PEREIRA
Keyword(s):  
Design Thinking ◽  
Technology Development ◽  
Complex Problem ◽  
Project Team ◽  
Healthcare Sector ◽  
Strategy Development ◽  
Patient Specific ◽  
Critical System ◽  
Patient Specific Implants ◽  
Human Centred Design

Design thinking and human-centred design is often discussed and utilised by teams and organisations seeking to develop more optimal, effective or innovative solutions for better customer outcomes. In the healthcare sector the opportunity presented by the practice of human-centred design and design thinking in the pursuit of better patient outcomes is a natural alignment. However, healthcare challenges often involve complex problem sets, many stakeholders, large systems and actors that resist change. High-levels of investment and risk aversion results in the status quo of traditional technology-led processes and analytical decision-making dominating product and strategy development. In this case study we present the opportunities, challenges and benefits that including a design-led approach in developing complex healthcare technology can bring. Drawing on interviews with participants and reflections from the project team, we explore and articulate the key learning from using a design-led approach. In particular we discuss how design-led practices that place patients at the heart of technology development facilitated the project team in aligning key stakeholders, unearthing critical system considerations, and identifying product and sector-wide opportunities.

scholarly journals Ethnic variation in medial orbital wall anatomy and its implications for decompression surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Minhui Amy Chan ◽  
Farah Ibrahim ◽  
Arjunan Kumaran ◽  
Kailing Yong ◽  
Anita Sook Yee Chan ◽  
...  
Keyword(s):  
Relative Position ◽  
Ethmoid Sinus ◽  
Decompression Surgery ◽  
Ethnic Variation ◽  
Sinus Wall ◽  
Orbital Wall ◽  
Mean Width ◽  
Significant Difference ◽  
The Mean ◽  
Medial Orbital Wall

Abstract Background To describe the inter-ethnic variation in medial orbital wall anatomy between Chinese, Malay, Indian and Caucasian subjects. Methods Single-centre, retrospective, Computed Tomography (CT)-based observational study. 20 subjects of each ethnicity, were matched for gender and laterality. We excluded subjects younger than 16 years and those with orbital pathology. OsiriX version 8.5.1 (Pixmeo., Switzerland) and DICOM image viewing software CARESTREAM Vue PACS (Carestream Health Inc., USA) were used to measure the ethmoidal sinus length, width and volume, medial orbital wall and floor angle and the relative position of the posterior ethmoid sinus to the posterior maxillary wall. Statistical analyses were performed using Statistical Package for Social Sciences version 25.0 (IBM, USA). Results There were 12 males (60 %) in each group, with no significant difference in age (p = 0.334–0.994). The mean ethmoid sinus length in Chinese, Malay, Indian and Caucasian subjects, using the Chinese as reference, were 37.2, 36.9, 38.0 and 37.4mm, the mean width was 11.6, 10.5, 11.4 and 10.0mm (p = 0.020) and the mean ethmoid sinus volume were 3362, 3652, 3349 and 3898mm3 respectively. The mean medial orbital wall and floor angle was 135.0, 131.4, 131.0 and 136.8 degrees and the mean relative position of posterior ethmoid sinus to posterior maxillary wall were − 2.0, -0.2, -1.5 and 1.6mm (p = 0.003) respectively. Conclusions No inter-ethnic variation was found in decompressible ethmoid sinus volume. Caucasians had their posterior maxillary sinus wall anterior to their posterior ethmoidal walls unlike the Chinese, Malay and Indians. Awareness of ethnic variation is essential for safe orbital decompression.

Bony landmarks of the medial orbital wall: An anatomical study of ethmoidal foramina

2013 ◽  
Vol 27 (4) ◽  
pp. 570-577 ◽  
Author(s):  
Maria Piagkou ◽  
Georgia Skotsimara ◽  
Aspasia Dalaka ◽  
Eftychia Kanioura ◽  
Vasiliki Korentzelou ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Bony Landmarks ◽  
Orbital Wall ◽  
Medial Orbital Wall

scholarly journals Six cases of fracture of the medial orbital wall.

1986 ◽  
Vol 79 (12) ◽  
pp. 2049-2053
Author(s):  
Hiroshi FUJITA ◽  
Yasushi MATSUMOTO ◽  
Masafumi TANI ◽  
Kako NAKANO ◽  
Masanori SADAMOTO ◽  
...  
Keyword(s):  
Orbital Wall ◽  
Medial Orbital Wall
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