ORBITAL RECONSTRUCTION BASED ON THE DIGITAL MODELING: ASSESSMENT OF AUTOMATED SEGMENTATION EFFICACY
DOI:
https://doi.org/10.35220/2078-8916-2021-40-2.7Keywords:
orbital reconstruction, patient-specific implants, automated segmentationAbstract
The purpose of the study: to investigate the clinical efficacy of patient-specific implants (PSI) for orbital reconstruction, based on an automated algorithm of virtual restoration of the orbit. Materials and methods. The results of treatment of 58 patients #, who underwent orbital wall reconstruction using PSI, were analysed. Depending on the algorithm of PSI design, all patients were divided into two groups - the main and control. In the main group, which included 31 patients, the design of PSI was based on the use of an automated algorithm for segmentation and virtual restoration of orbital integrity, while in the control - virtual replacement of defects was performed in a semiautomatic mode (“slice-by-slice method”). Results. The average volume difference between intact and broken orbit before surgery was 3.4 ± 2.5 cm3 in the main group and 2.8 ± 1.1 cm3 in the control (p> 0.05), and after surgery - 0.68 ± 0.28 cm3 and 0.71 ± 0.21 cm3 respectively (p> 0.05). Immediately before the surgical stage of treatment, the frequency of post-traumatic enophthalmos in the main group was 70.1%, and in the control - 74.1%, then after surgery no case of residual enophthalmos was detected. The difference in the shape of the orbit did not statistically differ in both groups and was 3.3 ± 3.5% and 3.25 ± 2.5%, respectively (p>0,05). The mean duration of the computer design phase in the main group was 36.7 ± 6.9 minutes versus 72.9 ± 7.7 minutes in the control group (p <0.001). In the main group, the intervention lasted an average of 57.5 ± 14.7 minutes, while in the control group – 58.3 ± 11.3 minutes (p> 0.05). Conclusions. According to the results, PSIs based on automated algorithms of segmentation have comparable clinical efficacy to traditional digital orbit reconstruction protocols and can therefore be recommended as the method of choice for replacing orbit defects. The study of the clinical breadth of their practical application is the task of further research on this issue.
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