P63. A Virtual Reality Workflow For Facial Trauma: Virtual Reduction, Rapid 3D Printing, and Plate Bending

PURPOSE: The ability to understand complex three-dimension (3D) relationships is a foundation of craniofacial surgery and virtual reality (VR) offers real time, hands-on visualization of these relationships. The aim of this study was to evaluate the application and evolution of VR at our institution in the setting of craniofacial trauma, illustrating the development of a trauma workflow. METHODS: All patients who had VR used as part of facial fracture treatment were audited from first documented use in 2020 to 2024 at a single institution. RESULTS:: VR was used in 146 cases of craniofacial trauma. The number of procedures increased year over year, with 6 cases in 2020, 66 cases in 2023, and 36 cases currently in 2024 on pace to reach more than 50 cases by 2025. Surgeries took place across two hospitals with four plastic surgeons. Initially, simple VR visualization was used for fractures. With time, a workflow was developed wherein fractures were segmented in VR, reduced models were 3D printed onsite, and plates were pre-bent to the reduced models and sterilized (90.1% of procedures). Turnaround time has decreased for rapid 3D printing to 10-20 minutes for segmentation and reduction, and 12 hours for printing reduced models. This workflow now makes surgery planning possible with an overnight turnaround. CONCLUSION: VR allows for the manipulation of bone in 3D including segmentation of individual fracture fragments and reduction. We demonstrate an evolution of VR use from visualization to rapid 3D printing of reduced models.