Correction of Secondary Exophthalmos Caused by Lateral Orbital Rim Recession: Add-on Implants Through a 3D Approach.

Abstract

Improving exophthalmos is a crucial aspect of treatment for patients with syndromic craniosynostosis. However, in patients who have undergone previous treatments including fronto-orbital advancement and Le Fort III distraction osteogenesis and who have reached skeletal maturity, the recurrence of exophthalmos is not uncommon. The severity of the exophthalmos may vary. Whether secondary correction involving osteotomy should be performed or symptomatic treatment strategies should be adopted is a dilemma, and the patient's symptoms and background and the invasiveness of the surgery should also be considered. Additionally, the accurate measurement and treatment of exophthalmos require the expertise of surgeons. This report introduces self-developed orbital wall implants generated through 3-dimensional simulation and 3-dimensional printing. The patient was a 23-year-old woman with Crouzon syndrome and recurrent exophthalmos. After surgery, the exophthalmos and facial appearance were improved. The use of custom-made implants provides advantages over the conventional osteotomy method; it is less invasive, involves a simple surgical procedure, and offers cost and time savings.