TY - JOUR
T1 - Is there more to the clinical outcome in posttraumatic reconstruction of the inferior and medial orbital walls than accuracy of implant placement and implant surface contouring? A prospective multicenter study to identify predictors of clinical outcome
AU - Zimmerer, Rüdiger M.
AU - Gellrich, Nils Claudius
AU - von Bülow, Sophie
AU - Strong, Edward Bradley
AU - Ellis, Edward
AU - Wagner, Maximilian E.H.
AU - Sanchez Aniceto, Gregorio
AU - Schramm, Alexander
AU - Grant, Michael P.
AU - Thiam Chye, Lim
AU - Rivero Calle, Alvaro
AU - Wilde, Frank
AU - Perez, Daniel
AU - Bittermann, Gido
AU - Mahoney, Nicholas R.
AU - Redondo Alamillos, Marta
AU - Bašić, Joanna
AU - Metzger, Marc
AU - Rasse, Michael
AU - Dittman, Jan
AU - Rometsch, Elke
AU - Espinoza, Kathrin
AU - Hesse, Ronny
AU - Cornelius, Carl Peter
N1 - Publisher Copyright:
© 2018 The Authors
PY - 2018/4
Y1 - 2018/4
N2 - Purpose: Reconstruction of orbital wall fractures is demanding and has improved dramatically with the implementation of new technologies. True-to-original accuracy of reconstruction has been deemed essential for good clinical outcome, and reasons for unfavorable clinical outcome have been researched extensively. However, no detailed analysis on the influence of plate position and surface contour on clinical outcome has yet been published. Materials and methods: Data from a previous study were used for an ad-hoc analysis to identify predictors for unfavorable outcome, defined as diplopia or differences in globe height and/or globe projection of >2 mm. Presumed predictors were implant surface contour, aberrant implant dimension or position, accuracy of reconstructed orbital volume, and anatomical fracture topography according to the current AO classification. Results: Neither in univariable nor in multivariable regression models were unfavorable clinical outcomes associated with any of the presumed radiological predictors, and no association of the type of implant, i.e., standard preformed, CAD-based individualized and non−CAD-based individualized with its surface contour could be shown. Conclusion: These data suggest that the influence of accurate mechanical reconstruction on clinical outcomes may be less predictable than previously believed, while the role of soft-tissue−related factors may have been underestimated.
AB - Purpose: Reconstruction of orbital wall fractures is demanding and has improved dramatically with the implementation of new technologies. True-to-original accuracy of reconstruction has been deemed essential for good clinical outcome, and reasons for unfavorable clinical outcome have been researched extensively. However, no detailed analysis on the influence of plate position and surface contour on clinical outcome has yet been published. Materials and methods: Data from a previous study were used for an ad-hoc analysis to identify predictors for unfavorable outcome, defined as diplopia or differences in globe height and/or globe projection of >2 mm. Presumed predictors were implant surface contour, aberrant implant dimension or position, accuracy of reconstructed orbital volume, and anatomical fracture topography according to the current AO classification. Results: Neither in univariable nor in multivariable regression models were unfavorable clinical outcomes associated with any of the presumed radiological predictors, and no association of the type of implant, i.e., standard preformed, CAD-based individualized and non−CAD-based individualized with its surface contour could be shown. Conclusion: These data suggest that the influence of accurate mechanical reconstruction on clinical outcomes may be less predictable than previously believed, while the role of soft-tissue−related factors may have been underestimated.
KW - Blow-out fracture
KW - Clinical outcome
KW - Orbital fracture
KW - Orbital implant
KW - Predictor
KW - Regression analysis
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U2 - 10.1016/j.jcms.2018.01.007
DO - 10.1016/j.jcms.2018.01.007
M3 - Article
C2 - 29530645
AN - SCOPUS:85043294418
SN - 1010-5182
VL - 46
SP - 578
EP - 587
JO - Journal of Cranio-Maxillofacial Surgery
JF - Journal of Cranio-Maxillofacial Surgery
IS - 4
ER -