Indication, clinical outcomes, and positioning accuracy of polyetheretherketone patient-specific implants (PEEK PSI) in orbital surgery
Author: Amir H. Zamanipoor Najafabadi
Base Hospital / Institution: Leiden University Medical Center
ePoster presentation
Abstract ID: 24-423
Purpose
We describe the feasibility of orbital bone reconstruction with computer aided designed and manufactured (CAD/CAM) patient specific implants (PSIs) made from polyetheretherketone (PEEK) in patients who underwent surgery with (partial) orbital bone removal for different pathologies. Clinical outcomes and complications are described as well as positioning accuracy.
Methods
For all patients who received an orbital PEEK PSI between 2016 and 2021, we described proptosis, visual acuity, visual fields, cosmetic satisfaction and complications. Positioning accuracy of the PEEK-PSI was assessed for patients with available postoperative CT scans, which were aligned with the preoperative CT scans, followed by segmentation of the postoperative PSI position. The Euclidean distance and rotation between the realized PSI position and the planned PSI position were calculated.
Results
Reconstruction with PEEK-PSI was performed in 27 patients: sphenoid ridge meningioma and spheno-orbital meningioma (n=21), Juvenile psammomatoid ossifying fibroma (JPOF, n=3), intraosseous hemangioma (n=1), orbital fracture (n=1), and osteoma (n=1). In three cases the PEEK PSI shape was slightly adjusted intraoperatively. Median preoperative proptosis was 5.0mm (IQR: 3.0;6.0), which significantly improved to 1.8mm (IQR: 1.0;3.0) 1 year postoperatively, p=0.03. Preoperative median visual acuity was 1.2 (IQR: 1.0;1.5), which remained stable after surgery (median 1.2, IQR: 1.1;1.5). Preoperative median visual field was -4.3dB (IQR: -9.5;-2.2), which improved to -2.1dB (IQR: -4.0;-0.3), p=0.04. All patients were satisfied with the cosmetic results. Complications were new visual field defects (n=1), an epidural hematoma (n=1), and a low-grade infection, requiring surgery (n=1). The mean Euclidian distance (n=11) between the realized PSI position and the planned PSI position was 3.7 ± 2.2 mm. The mean rotation deviation was 9.1 ± 5.2°. Data will be updated for the conference.
Conclusion
Reconstruction with CAD/CAM PEEK PSI can be used for a variety of pathologies and results in satisfying clinical and anatomical outcomes.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Larissa | Nagtegaal | Leiden University Medical Center |
| Roy P.J. | van den Ende | Leiden University Medical Center |
| Wouter A. | Moojen | Leiden University Medical Center |
| Wouter R. | van Furth | Leiden University Medical Center |
| Stijn W. | van der Meeren | Leiden University Medical Center |
