Computer guided calvarial bone grafting for reconstruction of orbital floor blow out fracture.

Abstract

Calvarial grafts represents a superior option for orbital floor reconstruction, however the difficulty of intraoperative moulding and placement remains as a major limitation. We used patient specific guides and sterolithographic models to facilitate this procedure. The study was conducted on 10 patients with orbital floor blow out fracture. A graft harvesting guide was virtually constructed based on the defect using mirroring of the normal side. The virtual guide and the defective orbital floor were then printed. The graft was harvested using the guide and adjusted to the defect using the model, finally seated in place. All patients showed no enophthalmos or diplopia. Orbital volume was comparable for both traumatised and normal orbits with no statistical significance difference (p value 0.28), and orbital volume ratio was 101.76±4.7%. The use of graft harvesting guide and orbital floor models for intraoperative graft moulding showed promising results.