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Computer-aided methods for single-stage fibrous dysplasia excision and reconstruction in the zygomatico-orbital complex

Igor Budak (Faculty of Technical Sciences, University of Novi Sad, Novi Sad, Serbia)
Aleksandar Kiralj (Medical Faculty, University of Novi Sad, Novi Sad, Serbia)
Mario Sokac (Faculty of Technical Sciences, University of Novi Sad, Novi Sad, Serbia)
Zeljko Santosi (Faculty of Technical Sciences, University of Novi Sad, Novi Sad, Serbia)
Dominic Eggbeer (National Centre for Product Design and Development Research, Cardiff Metropolitan University, Cardiff, UK)
Sean Peel (National Centre for Product Design and Development Research, Cardiff Metropolitan University, Cardiff, UK)

Rapid Prototyping Journal

ISSN: 1355-2546

Article publication date: 13 May 2019

Issue publication date: 12 July 2019

Abstract

Purpose

Computer-aided design and additive manufacture (CAD/AM) technologies are sufficiently refined and meet the necessary regulatory requirements for routine incorporation into the medical field, with long-standing application in surgeries of the maxillofacial and craniofacial regions. They have resulted in better medical care for patients and faster, more accurate procedures. Despite ever-growing evidence about the advantages of computer-aided planning, CAD and AM in surgery, detailed reporting on critical design decisions that enable methodological replication and the development and establishment of guidelines to ensure safety are limited. This paper aims to present a novel application of CAD and AM to a single-stage resection and reconstruction of fibrous dysplasia in the zygoma and orbit.

Design/methodology/approach

It is reported in sufficient fidelity to permit methods replication and design guideline developments in future cases, wherever they occur in the world. The collaborative approach included engineers, designers, surgeons and prosthetists to design patient-specific cutting guides and a custom implant. An iterative design process was used, until the desired shape and function were achieved, for both of the devices. The surgery followed the CAD plan precisely and without problems. Immediate post-operative subjective clinical judgements were of an excellent result.

Findings

At 19 months post-op, a CT scan was undertaken to verify the clinical and technical outcomes. Dimensional analysis showed maximum deviation of 4.73 mm from the plan to the result, while CAD-Inspection showed that the deviations ranged between −0.1 and −0.8 mm and that the majority of deviations were located around −0.3 mm.

Originality/value

Improvements are suggested and conclusions drawn regarding the design decisions considered critical to a successful outcome for this type of procedure in the future.

Keywords

Acknowledgements

This paper presents the results achieved in the framework of the project no. 114-451-2723/2016-03, funded by the Provincial Secretariat for Higher Education and Scientific Research, and within the project TR - 35020, funded by the Ministry of Education, Science and Technological Development of Republic of Serbia.

Citation

Budak, I., Kiralj, A., Sokac, M., Santosi, Z., Eggbeer, D. and Peel, S. (2019), "Computer-aided methods for single-stage fibrous dysplasia excision and reconstruction in the zygomatico-orbital complex", Rapid Prototyping Journal, Vol. 25 No. 4, pp. 728-737. https://doi.org/10.1108/RPJ-05-2018-0116

Publisher

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Emerald Publishing Limited

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