P-67915014-268 - Does intra-operative navigation improve accuracy of implant position in secondary reconstruction of large orbital defects?

Abstract

<h3>Background and Purpose</h3> Literature supporting use of intra-operative navigation (ION) in orbital reconstruction is abundant. However, evidence on the role of ION in improving orbital implant position is sparse. Our objective was to determine if ION influenced implant position accuracy in secondary orbital reconstruction. <h3>Methods</h3> This was designed as a prospective observational study comparing two groups of patients requiring secondary orbital reconstruction; the test group received intra-operative guidance with ION, while the control did not. The groups were matched for age and defect size. Primary outcome variables included assessment of deviations between the ideal implant position and achieved implant position in six degrees of freedom; horizontal, vertical and transverse (linear), pitch, roll and yaw (angular). Secondary outcome variables included assessment of procedural time. Descriptive and inferential statistics were used to compare means and variance. <h3>Results</h3> A total of 24 patients were recruited into the study with a mean age of 27.79 years. Results demonstrated that implant position accuracy was significantly superior in the transverse plane (medio-lateral) for the test group (p=0.03). The total duration of the procedure was longer by 8minutes (p=0.047), while surgery time was 15minutes shorter when using ION (p<0.001). This was due to the additional equipment setup time for the test group (mean 23mins, p<0.001). <h3>Conclusion</h3> The study demonstrated that ION may be a useful intra-operative guide to improve implant position in infero-medial orbital defects requiring reconstruction. ION also reduced the time required for intra-orbital dissection and positioning of the implant.