Page 21 - Advanced concepts in orbital wall fractures

Aims and outline of this thesis C1
The aim of this thesis is twofold. Firstly, the aim is to investigate the added value of several individual components in the workflow of computer- assisted orbital reconstruction. The hypothesis is that more detailed information provides better and more predictable outcome. The main focus is on diagnostics, preoperative planning, and intraoperative control. Secondly, the aim is to upgrade the clinical management of these fractures by evaluating the available literature and convert this into a new clinical protocol with special emphasis on functional outcome.
Introduction
In chapter 1 (this chapter), the general introduction and outline are presented.
Part I Technological advancements
Virtual planning software creates a better overview, more accurate measurements of the fracture site, and grants a valuable insight into the surgical dilemmas. Computer-assisted diagnostics, surgical planning, intraoperative navigation, and intraoperative imaging are ideally all incorporated in the workflow of orbital reconstruction.
Orbital wall fractures are often unilateral. Assessing the difference in volume between the affected and unaffected sides can be indicative for the severity of the fracture. Manual measurement is time-consuming and not applicable in clinical practice. Therefore, a (semi-)automatic method is a practical solution. In chapter 2, three (semi-)automatic methods to measure the orbital volume of the intact bony orbit are evaluated. One of the issues is that the orbital cavity has several apertures and to ensure an enclosed space, the orbital boundaries need to be defined with virtual planes. In this study, the aim is to test the speed, accuracy, and reproducibility of these methods.
If there is an indication for orbital reconstruction, the computer-assisted surgery workflow begins with segmentation and mirroring of the unaffected side onto the contralateral affected side. Virtual preoperative
General introduction and outline
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