Diagnosis

Orbital floor fractures are one of the most common facial fractures: in 30-40% of the cases the orbit is injured; in 10% of the cases an isolated orbital wall fracture is reported. Patients exposed to a traumatic event and suspected of suffering from a fracture of the orbital floor typically undergo a 1.0-1.5mm CT scan of the orbit. Depending on the severity of the injury, treatment may include medications (steroids/antibiotics); often surgical intervention is neccessary.

Surgical Treatment

Surgery is usually undertaken within 2 weeks from the trauma. The herniated structures are restored into the orbital cavity.

The entire fracture site has to be properly disssected and fully covered with an appropriate implant (available in various materials, types, and size for the reconstruction of the orbit). Shaping the implant to its desired form and fixing it to its final position is key to the success of the surgery. A postoperative CT scan is often recommended to verify the placement of the implant.

Recovery is often prolonged, complications (displacement of the implant, herniation of tissue through a residual hole) can lead up to follow-up surgries or cause visual loss, even years after the operation.

The Role of 3D Printing

Picture of the patient-specific 3D print.

Picture of the patient-specific 3D print.

While CT-based surgical planning lacks haptic feedback, modern 3D printing solutions allow to create solid, bone like structures. Based on these physical models, symmetries can be verified by comparing the healthy and the damaged sides, implants can be chosen and pre-bent before the operation.

FORMED.SWISS

In the current use case, we present the orbital cavities and the fracture of the orbital floor of an elderly male patient. The model was prepared and printed by Sébastien Martinerie, 3D printing specialist and director of FORMED. The company is specialized in creating high quality 3D prints for preoperative planning in Lausanne, Switzerland.

The 3D model was created with Rhino3DMedical and printed with a Formlabs Form 2 desktop 3D printer using grey resin.

Tutorial

Learn how to create a patient-specific 3D-printable model of the orbital floor with Rhino3DMedical.