Secondary midfacial reconstruction using diffenrent surgical techniques and computer assisted surgery

Aim Aim of this retrospective study was to assess the outcome after secondary midfacial reconstruction using different operation techniques and computer assisted surgery. Functional and aesthetic aspects as well as experiences are reported. Patients and methods 18 patients were assessed for enophthalmos, diplopia, and aesthetics during a follow-up period of up to 2.5 years. Results In 40% of the patients several techniques for soft and hard tissue reconstruction were used. In 5 of the 9 patients diplopia was improved; in 4 patients there was no change. A significant enophthalmos was corrected in 8 out of 12 patients. After additional surgery 6 patients had a good aesthetic result, 7 a satisfactory and 5 a poor. Conclusion For secondary midfacial reconstruction often a combination of different surgical techniques is neccessary. Bony asymmetries and enophthalmos were successfully corrected, however, functional and aesthetic impairment due to bad soft tissue condition are difficult to correct. Computer assisted surgery is helpful for dissection within the orbit, for graft placement, and for positioning of osteotomized segments.