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• W2121566551 abstract "Injuries to the face from trauma or tumor surgery sometimes lead to loss of facial structures such as eyes, ears and nose. Loss of these structures is disfigurative and may cause the patient a social handicap. Reconstruction of lost tissue with an epithesis has been used for many years. During this time, the most important factor for a successful cosmetic result has been the artistic ability of the anaplastologist to create a mirrored image of the healthy side. One of the major problems in making the epithesis is correct placement of the epithesis to achieve restored symmetry of the face. Over the years different aids in placing the epithesis have been utilized, for example the symetrograph (Reumuth et al, 1965) and later projection of an inverted photo over a plaster cast of the defect (Frenkel, 1970). Another problem is that conventional impression technique may deform soft tissues due to pressure of the impression material and subsequently cause discomfort to the patient. Technical advances with computed tomography (CT), magnetic resonance imaging (MRI), laser scanners and structured light techniques together with surgery planning software have enabled 3-dimensional reconstructions of the facial anatomy (Kau et al, 2007). These techniques may facilitate both design and manufacture of facial epithesis (Feng et al, 2009). iPlan is a software mainly intended for preoperative planning of CMF reconstructive navigation guided bone surgery. 3D models have during recent years proven useful for preoperative evaluation and operation planning. The present case illustrates a new application for iPlan (iPlan v.3.0; Brainlab AG, Feldkirchen, Germany), with the possibility for soft tissue-based computer aided design of an orbital epithesis. A 95-year-old man previously was treated for a recurrent basal cell carcinoma with removal of his left eye followed by radiotherapy. For many years the patient has used an orbital prosthesis but due to soft tissue contraction and further surgery due to recurring tumor he now was a candidate for an epithesis. Implant placement was not considered an option due to poor tissue quality and the patient's general health. As a part of regular tumor treatment follow up a CT scan was made. The DICOM images were processed in the iPlan software and soft tissue profile of the face was analyzed. To create facial symmetry the unaffected healthy side was aligned and mirrored over the defect on the left side. Subsequently the mirrored right side was subtracted from the left side profile leaving a volume difference representing the design of the epithesis. The epithesis was exported in STL-format and a plaster model was printed in a 3D printer (Zprint 450; Z Corporation, Burlington, MA). The model was then used by the anaplastologist to shape and model the final silicone epithesis. Retention of the epithesis was excellent. The new application of soft tissue-based design was shown a useful tool in restoring facial symmetry and placement of an orbital epithesis. One limitation of this method is however that it is based on an x-ray investigation and that it may be difficult to obtain a normal relaxed posture with open eyes during such procedure." @default.
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• W2121566551 date "2011-09-01" @default.
• W2121566551 modified "2023-10-18" @default.
• W2121566551 title "Soft Tissue Design - A New Application for CMF Planning Software iPlan" @default.
• W2121566551 doi "https://doi.org/10.1016/j.joms.2011.06.038" @default.
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