Page 143 - Advanced concepts in orbital wall fractures

Summary
This PhD thesis provides detailed insight into several components of computer-assisted orbital reconstruction and contributes to the improvement of orbital wall fracture management. Technology fulfills an important role in the current treatment of these fractures. A substantial amount of research is required to prove the effectiveness of newly developed technological aids. While technological developments are rapidly evolving, there is still a lack of consensus on certain aspects of treatment. Many decades ago, two opposing treatment strategies emerged: the predominantly nonsurgical approach and the early surgical approach. There is no generally accepted treatment protocol.
Several topics are introduced in chapter 1 to illustrate why there is a necessity for technological tools and clear treatment protocols. The topics discussed are anatomy, trauma mechanism, surgical principles (surgical approach, anatomical landmarks, and implant material), technological developments, and the management of orbital fractures.
The orbital anatomy is complex. The orbital cavity is compact, has a conical shape, and the orbital floor and medial wall are thin and fragile. The soft tissue consists of neurovascular structures, adipose tissue, connective tissue, muscles, and the globe. These are all delicate structures and especially the connective tissue has an intricate architecture with fascia sheaths, septa, ligaments, and the periorbita, that function as a suspension system. Trauma often involves a fracture of the floor and medial wall and it is very important to which extent the suspension system is affected.
A clear overview is important during orbital reconstruction because of C8 the complex anatomy. This can be achieved with an adequate surgical
approach, such as the transconjunctival approach. Surgical guidance is
obtained by the identification of multiple anatomical landmarks. Besides
a sound overview during surgery, the success of the reconstruction is also based on the implant used. A titanium implant is considered the gold standard, as it adheres best to the demands of surgery. To further facilitate the surgeon, technological aids have been implemented in
Summary in English and Dutch
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