Chun-Lin Zong,Yu-Lin Shi,Jun-Qi Jia,Ming-Chao Ding,Shi-Ping Chang,Jin-Biao Lu,Yuan-Li Chen,Lei Tian.[J].Chin J Traumatol,2021,24(1):11-17. [doi]
A retrospective study to compare the treatment outcomes with and without surgical navigation for fracture of the orbital wall
  
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KeyWord: Computer-assisted surgical navigationsystemOrbital wall fractureOrbital reconstruction
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Author NameAffiliation
Chun-Lin Zong State Key Laboratory of Military Stomatology, National Clinical Research Center of Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032, China 
Yu-Lin Shi State Key Laboratory of Military Stomatology, National Clinical Research Center of Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032, China 
Jun-Qi Jia State Key Laboratory of Military Stomatology, National Clinical Research Center of Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032, China 
Ming-Chao Ding State Key Laboratory of Military Stomatology, National Clinical Research Center of Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032, China 
Shi-Ping Chang State Key Laboratory of Military Stomatology, National Clinical Research Center of Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032, China 
Jin-Biao Lu State Key Laboratory of Military Stomatology, National Clinical Research Center of Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032, China 
Yuan-Li Chen State Key Laboratory of Military Stomatology, National Clinical Research Center of Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032, China 
Lei Tian State Key Laboratory of Military Stomatology, National Clinical Research Center of Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032, China 
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Abstract:
      Purpose: To evaluate the outcomes with and without aid of a computer-assisted surgical navigation system (CASNS) for treatment of unilateral orbital wall fracture (OWF). Methods: Patients who came to our hospital for repairing unilateral traumatic OWF from 2014 to 2017 were included in this study. The patients were divided into the navigation group who accepted orbital wall reconstruction aided by CASNS and the conventional group. We evaluated the surgical precision in the navigation group by analyzing the difference between actual postoperative computed tomography data and preoperative virtual surgical plan through color order ratios. We also compared the duration of surgery, enophthalmos correction, restoration of orbital volumes, and improvement of clinical symptoms in both groups systemically. Quantitative data were presented as mean ± SD. Significance was determined by the two-sample t-test using SPSS Version 19.0 A p < 0.05 was considered statistically significant. Results: Seventy patients with unilateral OWF were included in the study cohort. The mean difference between preoperative virtual planning and actual reconstruction outcome was (0.869 ± 0.472) mm, which means the reconstruction result could match the navigation planning accurately. The mean duration of surgery in the navigation group was shorter than it is in the control group, but not significantly. Discrepancies between the reconstructed and unaffected orbital-cavity volume and eyeball projection in the navigation group were significantly less than that in the conventional group. One patient had remnant diplopia and two patients had enophthalmos after surgery in the navigation group; two patients had postoperative diplopia and four patients had postoperative enophthalmos in the conventional group. Conclusion: Compare with the conventional treatment for OWF, the use of CASNS can provide a significantly better surgical precision, greater improvements in orbital-cavity volume and eyeball projection, and better clinical results, without increasing the duration of surgery.
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