Inferior orbital rim augmentation in facial palsy

Relevance Negative orbital vector and midface ptosis complicate correction of paralytic lagophthalmos (PL). To compensate for them, SOOF lifting and placement of an implant of the lower orbital rim are known [1–5]. Objective To present the capabilities of a new method of augmentation of the lower orbital rim. Material and methods Before surgery, OS - negative orbital vector, MRD2 = 8 mm, MLD2 = 2 mm, lagophthalmos 2 mm. Multispiral computed tomography of the skull was performed, a 3D model and an individual stereolithographic model were created, repeating the topography of the lower orbital rim, an individual implant was made from a mixture of titanium powder "BT-6". Transconjunctival access, canthotomy, lower cantholysis were performed. Radiosurgical dissection of the conjunctiva, blunt separation of tissues, exposure and separation of the periosteum of the lower edge of the orbit, installation of a custom implant, fixation with screws. Results After 6 months, a positive orbital vector, the position of the lower eyelid is correct, there is no lagophthalmos. Conclusion The use of 3D printing ensures safe augmentation of the lower edge of the orbit, allows optimization of surgical treatment of PL [5]. Key words: facial paralysis; lagophthalmos; 3D modeling; stereolithography; augmentation