Low-Cost, Three-Dimensionally–Printed, Anatomical Models for Optimization of Orbital Wall Reconstruction

Mastery of craniomaxillofacial reconstruction has been traditionally considered to be learning curve dependent, often with inconsistent results during the skill acquisition phase. Until recently, the overall success in bony oncologic reconstruction of the craniomaxillofacial skeleton has relied mainly on the use of 2D imaging modalities, as well as surgical trial-and-error. Virtual surgical planning (VSP) and computer aided design (CAD)/computer aided modeling (CAM) are gaining traction in oncologic applications and offers opportunity for increased accuracy, improved efficiency, and enhanced outcomes. Its role in oncologic head and neck reconstruction has not been formally evaluated.

After studying this article, the participant should be able to: 1. Explain the epidemiology, anatomy, and pathophysiology of orbital floor fractures. 2. Select the optimal timing of--and understand the indications for-operative repair of orbital floor fractures. 3. List advantages and disadvantages of the surgical approaches and materials available for orbital floor reconstruction. 4. Identify special considerations in treating pediatric patients presenting with orbital floor fractures.

Virtual planning and guided surgery with or without prebent or milled plates are becoming more and more common for mandibular reconstruction with fibular free flaps (FFFs). Although this excellent surgical option is being used more widely, the question of the additional cost of planning and cutting-guide production has to be discussed. In capped payment systems such additional costs have to be offset by other savings if there are no special provisions for extra funding. Our study was designed to determine whether using virtual planning and guided surgery resulted in time saved during surgery and whether this time gain resulted in self-funding of such planning through the time saved.