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194Chapter11Figure9Case2orbitalreconstruction Topleftoriginalandsurgicalguide ToprightbarreconstructedintemplateBecausethebarwasbendedatpoint1andnotcompletelycutasmalldiscrepancycouldbenoticed(yellowarrow2)thatresultedinasteeperreconstructionoftheorbitalbar(downunder)The post-op analysis of the first reconstruction revealed that it is possible to performtheosteotomiesaccording the VSP withoutdemarcationorreconstructionguidesbutfindingtheexactorientationofthebonesegmentsremainschallenging ThiswasthemostprominentaberrationinthiscaseInthesecondsurgeryofthefirstcase(case1-part2)thesurgicalguideshelpedtomakethesurgicalprocedurefasterandmorefluentMoreover,thepost-opCT-scanwaslargelyinaccordancewiththe VSP. ThepositionsandorientationsofalmostallbonesegmentsmatchedtheVSPandtheaimedvolumeincreasewasamplyachievedandthereforethesurgicalgoalwasrealizedThesecondcasehelpedusrealizethatlargerandsimplerguidesshouldbeusedduringfronto-orbitaladvancementInadditionweshouldbemorestrictlyduringsurgerytoachievetheplannedorbitalangle
