The value of virtual simulation for preoperative planning in surgical correction of orbital hypertelorism

• Published in: European journal of plastic surgery 2023-12, Vol.46 (6), p.969-978
• Main Authors: El-Sayed, Ibrahim Moustafa, ElBanoby, Tarek Mahmoud, Moustafa, Waleed Ahmed, Shoukr, Tarek Gamal
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Paper; Plastic Surgery
• ISSN: 1435-0130; 1435-0130
• DOI: 10.1007/s00238-023-02084-y

Background One of the most complicated and challenging problems in the field of craniofacial surgery is orbital hypertelorism (ORH). It was described as a wider-than-normal interorbital distance. It may only affect one side sometimes, or it may be bilateral. This study aims to evaluate the accuracy of virtual simulation for preoperative planning in hypertelorism surgery. Methods Ten patients who were hospitalized at Tanta University Hospitals’ Plastic and Reconstructive Surgery Department were included in this prospective study for ORH surgery. All patients underwent full history taking, clinical examinations, and routine laboratory investigations. Preoperative planning: 3D visualization and simulation composed of the following stages: visualization of the craniofacial skeleton, osteotomy simulation, and D facial skeleton prediction. Results The planned interorbital distance (IOD) in the virtual simulation model ranged between 20 and 25 with a mean value of 21.95 ± 1.36 mm. The postoperative IOD ranged between 19 and 24 with a mean value of 20.9 ± 1.52 mm. IOD was insignificantly different between post and planned IOD ( P  = 0.112). Relapse ranged between 0 and 4 mm after a 1-year follow-up with a mean value of 2.10 ± 1.50, indicating the value of virtual simulation in preoperative planning to achieve accurate sites for osteotomies and the amount of interorbital bone to be removed. Conclusions Virtual 3D planning allows for improved surgical planning and a sharper concentration on crucial technical maneuvers during surgery. The main advantage of this technology is that repositioning is significantly more accurate and efficient than the conventional technique. Level of evidence: Level IV, Therapeutic study.