Innovative Solutions in Orbital Fracture Surgery

The eyeball is one of the most vulnerable human body parts to external impacts because the orbit and adipose tissue that protects the eyeball is fragile. Therefore, an orbital fracture may occur when a strong impact is applied to the 'orbit,' the bony cavity in the skull that houses the globe of the eye (eyeball)

However, minor fractures are challenging to detect because there are no specific symptoms. Many patients are unaware of the orbital fractures and then found out fractures during CT scans for other reasons. At this time, some people may vomit or have nosebleeds, but this is not a common symptom. Of course, orbit fractures due to severe impact may cause symptoms such as bleeding or swelling of the eyelids.

Therefore, an orbital fracture should be suspected when you experience swollen eyes, nosebleeds, bleeding from the eyelids and conjunctiva, or facial sensory abnormalities in a nose, cheeks, and lips after an external impact. You should visit the hospital immediately if you experience eye movement disorder and double vision (the phenomenon of seeing multiple objects) due to damage to the muscles that move the eyeball. Suppose the treatment time for an orbital fracture is delayed. In that case, you can have visual acuity loss, hemorrhagic tumor, damage to the extraocular muscle or optic nerve, and the problem of sunken eyes may occur.

■Facial bone, the most complex structure in the human body

Fortunately, not all orbital fracture patients need surgery. Simple fractures can be treated with antibiotics and steroids.

However, surgery must be performed if the eye muscle is caught in the fracture site, causing diplopia, or if the orbital fracture is severe with a high possibility of ocular depression. The surgery should be performed after the swelling is relieved within 10 to 14 days to prevent complications of the ocular depression. The operation "orbital fracture reduction surgery" removes the fractured fragments and reconstructs the orbit with an artificial prosthesis (implant).

The problem is that the facial bone has the most complex structure in the human body, so it is difficult to cut a flat implant to fit the shape of the patient's affected area. In particular, the orbital bone is a socket-type structure made up of 7 bones, and the shape is distinct for each person.

Therefore, if the implant contour is adjusted incorrectly, the orbital volume may differ from that of the usual side, or aftereffects such as diplopia may remain. Suppose the implant is cut according to the patient's affected area using the implant guide. In that case, the chance of side effects is diminished, and daily life is possible without discomfort after surgery.

In March, AnyMedi Solution's 'Guidance tailored to patients to produce artificial prosthesis implanted during orbital fracture reduction surgery (from now on referred to as orbital fracture implant guide)' was selected as an innovative medical technology (No. 2022-63). Now it is attracting public attention by further improving the accuracy of orbital fracture surgery.

■The orbital fracture implant guide enhances surgical accuracy and reduces ·operation time.

Recent advances in imaging diagnostics and the development of several implants have shown a good prognosis for severe fractures.

However, in the conventional way of orbital fracture reduction surgery, medical staff cannot directly witness the patient's affected area. Thus, they use CT, X-ray, and MRI images to cut, bend the orbital implant, and form the shape to fit the affected area based on their own thoughts. Therefore, the skill level of the medical staff may affect the accuracy of matching the actual affected part. Also, there are limitations, such as re-calibration during the surgical procedure.

However, Anymedi Solutions' Orbital Fracture Implant Guide' uses a 3D printed patient-specific guide based on the patient's medical image (CT) information to cut, process the implant's curved surface, and shape the same way as the affected part. Since the guide is made based on the information obtained from the actual CT of each patient, doctors can accurately cut the implants, decreasing operation duration and improving surgical prognosis.

In addition, Anymedi Solution's orbital fracture implant guide's Safety and efficacy have been recognized through papers such as ▲Accuracy of 3D printed manual for the orbital implant, 2020 and ▲Generation of customized orbital implant template using 3D printing for orbital wall reconstruction orbital, 2018.

Annimedi Solution official declared, "The orbital fracture implant guide minimizes the operation time and improves the surgical prognosis by 3D printing the patient-customized guide with the patient's medical image before surgery. As it was designated as an innovative medical technology in recognition of its recognition, we will conduct more clinical research cases in the future to prove the effectiveness of the guide."