Reconstrução por espelhamento de fraturas de complexo orbitário: revisão de literatura e nota técnica com fluxo de trabalho em softwares livres

Abstract

The first report of the use of 3D printing technology to simulate a surgery was a mandibular reconstruction with a vascularized flap, in 1993. Images reconstructed before surgery were used to transfer the planning to the surgery, allowing the use of this technology in oral and maxillofacial surgery. The orbit has a complex anatomy and delicate structure, and its reconstruction is associated with complications or postoperative sequelae such as dystopia, enophthalmos, muscle incarceration, among others. Its reconstruction can benefit from 3D anatomical models that mirror the unaffected orbit. Therefore, the objective of this work was to review the studies with mirror reconstruction of the orbital complex, aiming to evaluate the different protocols, advantages, and disadvantages of the method, and to suggest a workflow with free software. A search was performed on PubMed, without date limits, written in Latin-Roman alphabet, using the descriptors “3d print”, “mirroring” and “orbit”. A total of 23 articles were found, of which 5 did not address orbital reconstruction, leaving 18 works for review. No description of the workflow to perform the method was found. The technique was used in cases of fracture (n=15), pathology reconstruction (n=2) or craniosynostosis (n=2). Randomized clinical trials (n=2), case reports (n=5), case series (n=1), retrospective studies (n=9) and prospective studies (n=1), totaling 298 orbits treated with the method. The use of this methodology significantly reduces the duration of surgery compared to the traditional method, does not present associated complications and increases the predictability of the reconstruction.