Accuracy of globe-sparing orbital reconstruction using individually bent titanium mesh: A comparative study

Accurate reconstruction of orbital and midfacial defects following extensive globe-sparing maxillectomy is challenging, due to the complex anatomy of facial skeleton. The aim of this study is to evaluate the outcomes of individually bent titanium mesh in navigation-assisted reconstruction of post-ablative orbits in comparison with that without intraoperative navigation. Forty-one patients undergone globe-sparing maxillectomy and orbital floor reconstruction using individually bent titanium mesh with or without intraoperative navigation were assessed. Pre- and postoperative orbital projection and volume measurements were performed on both orbits. The unaffected orbit was used as a control for comparison. True-to-original orbital reconstruction was achieved in this study. The average difference of globe projection and orbital volume between unaffected and reconstructed orbits was 0.8 ± 0.5 mm and 0.9 ± 1.2cm3, respectively, in navigation-assisted group. In non-navigation-assisted group, the average difference of globe projection and orbital volume of unaffected and reconstructed orbit was 0.7 ± 0.5 mm and 1.3 ± 1.3cm3, respectively. There was no statistical significance in mean differences between unaffected and affected globe projection (P = 0.744) and orbital volume (P = 0.677) in both groups. There was also no significant difference observed when comparing the mean differences between pre- and postoperative globe projection (P = 0.659) and orbital volume (P = 0.582) in both groups. While intraoperative navigation system was shown to be effective in orbital reconstruction in the past decade, equal satisfactory post-ablative orbital reconstruction can be achieved with individually bent titanium mesh with or without intraoperative navigation.