Page 93 - Advanced concepts in orbital wall fractures
P. 93

                                Intraoperative imaging Table 3 Satisfied with the position compared with unsatisfied with the position.
 Unsatisfied
Mean SD
Translation 3.59 mm 1.63 mm Pitch 2.28° 1.30° Yaw 13.02° 9.93° Roll 7.13° 4.65°
Mean
3.02 mm 2.73° 7.54° 3.49°
Satisfied
SD
p value
  The main reason to change the position of the implant was frontal malrotation roll (n=19). The second most important reason was axial malrotation yaw (n=9) and only once was it the translation of the implant. The sagittal malrotation pitch was never a reason to change the position of the implant.
Discussion C
Intraoperative imaging improves the reconstruction of the bony walls of 5 the orbit. It enables the surgeon to optimise the position of the implant
and minimise the need for revision surgery. Current mobile computed
tomography (CT) scanners are extremely useful as they have high
quality images, good operating speed, and they expose the patient to limited radiation14. The purpose of this study was to examine the effect of intraoperative imaging on the position of the implant fractures of the orbital floor and medial wall.
Intrasurgeon and intersurgeon repeatability were high for translation and pitch, indicating that the reproducibility in the use of intraoperative imaging is good. Yaw and roll were moderately high for the intraobserver repeatability and lower for the interobserver repeatability.
When comparing the implant’s first position with the final position, yaw and roll improved significantly. Translation and pitch did not. These results illustrate that the surgeon is able to see that the placement of the implant is not optimal, and is also able to adjust it accordingly. Pitch did not improve significantly, as none of the implants were positioned
1.35 mm 0.12 2.24° 0.27 5.87° 0.01 2.92° 0.00
 Argumentation for altering implant position
 91















































































   91   92   93   94   95