Patient before surgery

Treating the Patient Left Behind

In Venezuela, it’s quite common for hospitals to stabilize patients but not undertake additional reconstructive surgeries once their situation is no longer life threatening. Having survived a gunshot wound in the zygomaticofacial foramen, this young mother’s condition was stable, but far from ideal. Dr. Romulo Troncone knew that it could take years before Maria would receive a reconstructive surgery, or she may never even be treated at all. He approached OBL, knowing that their custom implants would be ideal for improving his patient’s self-esteem and quality of life.

Maria’s injuries were quite severe and included the loss of her left eyeball, skeletal deformities to her orbital and partial extrinsic muscle mobility. Previous surgeries were unsuccessful, as the scar tissue made the procedure extremely difficult. One year later, Dr. Troncone and the OBL team began designing a custom implant and planning her surgery, using Mimics and 3-matic software.

From Medical Scan to Surgical Plan

By importing the patient’s CT images into the medical edition of Materialise’s Mimics Innovation Suite, the engineers at OBL were able to virtually create a highly-accurate 3D reconstruction. This allowed the surgical team to fully understand her injury, including the remaining bone and soft tissue to work with. As symmetry is so critical for a successful outcome, the healthy side of her anatomy was mirrored to serve as a reference. With the flexible design tools in 3-matic, engineers created a new orbital floor. The engineers and surgeons worked together and reviewed various options digitally before finalizing their surgical plan and implant design, which was then 3D printed by selective laser sintering of grade two titanium power.

The surgical team then performed a facial reconstructive surgery of the orbital rim, floor and the lateral wall of the eye socket and zygomatic. Maria’s orbital floor healed, a prosthetic eye was placed and her aesthetics were restored. The medical team was glad to see their patient happy and confident again.

Revolutionizing Patient-Specific Implants

It’s crucial to plan reconstructions with extreme precision by using the most advanced tools available. Conventional implants are made of relatively flexible material that must be molded during the operation until it resembles the desired shape. This process is time consuming and relies heavily on the individual surgeon’s skills. Due to the complex nature of the procedure, sometimes the patient’s natural symmetry is lost and it may take more time to complete the surgical procedure. In this case, the custom implant was designed in advance on the computer using the patient’s own anatomy as a reference. This allows the engineers and surgeons to collaborate until everyone is pleased with the digital results. As the device is ready to be implanted before the procedure begins, surgery time is reduced. Shorter surgeries have advantages for the recovery of the patient and can reduce costs in the clinical establishment.

OBL

Established in 1996 in Paris, France, OBL is a manufacturer of implants for maxillofacial surgery, neurosurgery and plastic surgery. Relying on a high level of technical know-how and many years of experience in the development of osteosynthesis devices and 3D Printing techniques, OBL has developed a profound scientific base. Since 2005, OBL has specialized by investing significantly in the search for customized solutions that are in harmony with the morphology and physiology of each individual patient. Their goal is to redefine the standard of care by working closely with surgeons to apply advanced engineering techniques to achieve implant perfection for every patient they encounter. OBL is also part of the Materialise Group, a world leader in 3D Printing.

The Standard in ‘Engineering on AnatomyTM

The Mimics Innovation Suite turns 3D image data into high quality digital models in an accurate and efficient way.
Starting from CT, MRI or 3D ultrasound images, the Mimics Innovation Suite offers the most advanced image segmentation, the broadest anatomical measurement options, powerful CAD tools for Engineering on Anatomy and 3D Printing, and accurate model preparation for FEA and CFD. In this case, the medical edition of the Mimics Innovation Suite was used to:

  • Create an accurate 3D reconstruction of the defect
  • Mirror the healthy side of the patient’s anatomy and use it as a reference for reconstructive surgery
  • Design a new orbital floor directly on the patient’s anatomy, ensuring an optimal fit
  • Export the design for 3D Printing in titanium

 

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