ABSTRACT
PURPOSE: Recent advances in computer-modeling software allow reconstruction of facial symmetry in a virtual environment. This study evaluates the use of preoperative computer modeling and intraoperative navigation to guide reconstruction of the maxillofacial skeleton. METHODS: Three patients with traumatic maxillofacial deformities received preoperative, thin-cut axial CT scans. Three-dimensional reconstructions, virtual osteotomies, and bony reductions were performed using MIMICS planning software (Materialise, Ann Arbor, MI). The original and "repaired" virtual datasets were then imported into an intraoperative navigation system and used to guide the surgical repair. RESULTS: Postoperative CT scans and photographs reveal excellent correction of enophthalmos to within 1 mm in patient 1, significant improvement in symmetry of the nasoethmoid complex in patient 2, and reconstruction of the zygomaticomaxillary complex location to within 1 mm in patient 3. CONCLUSION: Computer modeling and intraoperative navigation is a relatively new tool that can assist surgeons with reconstruction of the maxillofacial skeleton.
Subject(s)
Computer-Aided Design , Maxillofacial Injuries/surgery , Plastic Surgery Procedures/methods , Surgery, Computer-Assisted/methods , Adult , Child , Computer Simulation , Enophthalmos/surgery , Ethmoid Bone/injuries , Female , Frontal Bone/injuries , Humans , Imaging, Three-Dimensional/methods , Male , Maxillary Fractures/surgery , Middle Aged , Models, Anatomic , Nasal Cavity/injuries , Orbital Fractures/surgery , Osteotomy/methods , Patient Care Planning , Skull Fractures/surgery , Software , Tomography, X-Ray Computed/methods , User-Computer Interface , Zygomatic Fractures/surgeryABSTRACT
PURPOSE OF REVIEW: Depending on the size, location, and extent of defects, a myriad of surgical approaches may be utilized to repair the eyelids. An understanding of the principles of lid reconstruction as well as orbital and periorbital anatomy is essential when approaching the repair of eyelid defects. While principles of eyelid reconstruction have been established, achieving good functional and aesthetic reconstruction remains challenging. This review examines the methodology of reconstructing eyelid defects, as reported over the last year. RECENT FINDINGS: Eyelid reconstruction continues to encompass a wide range of reconstructive options. Reports range from simple modifications of traditional techniques to the use of complex flaps and grafts. SUMMARY: While set algorithms have been proposed regarding eyelid reconstruction, the method of choice will ultimately depend on a combination of factors, including availability of tissues, and a surgeon's experience with the available modes of reconstruction.
Subject(s)
Eyelids/surgery , Plastic Surgery Procedures/methods , Eyelid Neoplasms/surgery , Eyelids/pathology , Humans , Ophthalmologic Surgical Procedures , Postoperative Complications/prevention & control , Skin Transplantation , Surgical FlapsABSTRACT
PURPOSE OF REVIEW: The present review summarizes traditional and advanced techniques used to reconstruct defects of the scalp. These deformities range from small defects that can be closed primarily to significant defects, which require free tissue transfer. RECENT FINDINGS: Increased use of tissue expanders, advancement rotational flaps, and hair transplantation has resulted in improved cosmetic outcomes for larger defects of the scalp. Free tissue transfer has provided a revolutionary method of reconstructing subtotal and total defects of the scalp, in particular those associated with neoplasms. SUMMARY: New advances in techniques of scalp reconstruction have provided improved outcomes in terms of cosmetic appearance and decreased morbidity for scalp reconstruction.
