P01 - Virtual Surgical Planning of Superior Orbital Rim Fractures in Complex Calvarial and Craniomaxillofacial Trauma

Abstract: Abstract

Purpose: The purpose of this study is to characterize the utility of virtual surgical planning (VSP) and pre-operatively printed anatomically perfected stereolithic models in treatment of superior orbital rim fractures in patients with complex calvarial and craniomaxillofacial trauma.

Methods: This study is a retrospective case series of subjects who were treated at the Massachusetts General Hospital by the Departments of Neurosurgery and Oral and Maxillofacial Surgery from the months of July 2022 to November 2022. Inclusion criteria include subjects who had both calvarial and craniomaxillofacial injuries requiring concurrent operative intervention on their superior orbital rim fractures. Primary outcome variables include variation in anatomic reduction post-operatively. Secondary variables include duration of surgery and re-operation rate. SPSS was utilized for descriptive statistics.

Results:
There were six orbits that met inclusion criteria (five subjects). The median age of subjects was 32.67 ± 19.11 years with 80% of subjects being male. In this study of six orbits, there were four left-sided orbital rim fractures (66.7%) and two right orbits (33.33%). After incorporation of this VSP methodology, there was a linear decrease in the operative time necessary for these complex calvarial craniomaxillofacial fractures with iterative cases (R2=0.69). The median difference in planned versus actual orbital volume achieved was 1.08 ± 2.72 cm3 . Only one subject required re-operation for vertical dystopia.

Conclusion: Virtual surgical planning is a useful adjunct in the treatment planning of orbital reconstruction in the setting of complex calvarial/craniomaxillofacial trauma. Stereolithic anatomically perfected models reduce operating time and improve the accuracy of the repair. Operative times were reduced with iterative use of VSP with anatomically perfected models.