Objectives: (1) To describe repair of complex orbital fractures using computer planning with preoperative virtual reconstruction, mirror image overlay, endoscopy, and surgical navigation. (2) To test the hypothesis that this technique improves outcomes in complex orbital fractures. Methods: A series of 113 consecutive severe orbital fracture cases was analyzed, 56 of which were performed with mirror image overlay guidance, and 57 of which were repaired without. Data were collected on patient characteristics, fracture severity, diplopia and globe position outcomes, complications, and need for revision surgery. Results: The mirror image overlay group showed decreased postoperative diplopia in all fracture types (P= .003); the effectiveness was maximal for fractures that involved 3 or 4 walls or the posterior one-third of the orbital floor (P < .001). The need for revision surgery was greatly reduced in this cohort (4% vs 20%; P=.03). Conclusions: The efficacy of mirror image overlay navigation and orbital endoscopy was studied in one of the largest series of complex orbital fractures in the literature. Based on statistically significant improved outcomes in postoperative diplopia and orbital volume, as well as the decreased need for revision surgery, we accept the hypothesis that mirror image overlay guidance improves outcomes in complex orbital reconstruction and recommend its use for complex orbital fracture repair.
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机译：目的：（1）用计算机规划，术前虚拟重建，镜像覆盖，内窥镜检查和手术导航来描述复杂眼眶骨折的修复。 （2）检验这种技术可改善复杂眼眶骨折预后的假设。方法：分析了113例连续的严重眼眶骨折病例，其中56例在镜下引导下进行，其中57例未经手术修复。收集有关患者特征，骨折严重程度，复视和球体位置结果，并发症以及翻修手术需求的数据。结果：镜检组显示所有类型的骨折术后复视减少（P = .003）;对于涉及3或4个壁或眼眶后壁三分之一的骨折，其效果最大（P <.001）。在这个队列中，翻修手术的需要大大减少了（4％vs 20％; P = .03）。结论：在文献中最大的一系列复杂眼眶骨折之一中，研究了镜象重叠导航和眼眶内窥镜检查的疗效。基于术后复视和眼眶容积的统计学显着改善，以及对翻修手术的需求减少，我们接受镜像覆盖指导可改善复杂眼眶重建结果的假设，并建议将其用于复杂眼眶骨折修复。
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