Orbital fractures pose specific challenge in its surgical management. One of the greatest challenges is to obtain satisfactory reconstruction by correct positioning of orbital implant. Intraoperative computed tomography (CT) scan may facilitate this procedure. The aim of this study was to describe the early use of intraoperative CT in orbital fractures repair in our center. The authors assessed the revision types and rates that have occurred with this technique. With the use of pre-surgical planning, optical intraoperative navigation, and intraoperative CT, the impact of intraoperative CT on the management of 5 cases involving a total number of 14 orbital wall fractures were described. There were 6 pure orbital blowout wall fractures reconstructed, involving both medial and inferior wall of the orbit fracturing the transition zone and 8 impure orbital wall fractures in orbitozygomaticomaxillary complex fracture. 4 patients underwent primary and 1 had delayed orbital reconstruction. Intraoperative CT resulted in intraoperative orbital implant revision, following final navigation planning position, in 40% (2/5) of patients or 14% (2/14) of the fractures. In revised cases, both implant repositioning was conducted at posterior ledge of orbit. Intraoperative CT confirmed true to original reconstruction of medial wall, inferior wall and transition zone of the orbit. Two selected cases were illustrated. In conclusion, intraoperative CT allows real-time assessment of fracture reduction and immediate orbital implant revision, especially at posterior ledge. As a result, no postoperative imaging was indicated in any of the patients. Long-term follow-ups for orbital fracture patients managed with intraoperative CT is suggested.

中文翻译：

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术中计算机断层扫描扫描术用于眼眶骨折的重建。

眼眶骨折对其手术治疗提出了特殊的挑战。最大的挑战之一是通过正确定位眼眶植入物获得满意的重建效果。术中计算机断层扫描（CT）扫描可能有助于此过程。这项研究的目的是描述术中CT在我们中心眼眶骨折修复中的早期应用。作者评估了该技术的修订类型和修订率。利用术前计划，术中光学导航和术中CT，描述了术中CT对5例涉及14例眼眶壁骨折的病例的处理效果。重建了6例纯眼眶爆裂壁骨折，累及眶内壁和下壁骨折的过渡区和8个不纯净的眶壁骨折。4例接受了原发性治疗，1例进行了眼眶重建延迟。在最终的导航计划位置之后，术中CT导致术中眶植入物翻修，占40％（2/5）的患者或14％（2/14）的骨折。在改良病例中，两种植入物的重新定位均在眼眶后壁进行。术中CT证实对内侧壁，下壁和眼眶过渡区的原始重建是正确的。说明了两个选定的案例。总之，术中CT可以实时评估骨折的复位情况和眼眶植入物即时翻修，特别是在后桥骨处。结果是，任何患者均未显示术后影像学检查。建议对术中CT处理的眼眶骨折患者进行长期随访。