Patient-specific 3D printing-guided surgical decompression for traumatic superior orbital fissure syndrome: a case report

Traumatic superior orbital fissure syndrome (SOFS) is an uncommon but potentially devastating complication of craniofacial trauma, resulting from injury or compression of the cranial nerves traversing the superior orbital fissure. The optimal management strategy remains controversial, particularly regarding the role and timing of surgical decompression. We report a case of traumatic SOFS caused by direct bony compression following craniofacial trauma. The patient presented with ophthalmoplegia, ptosis, sensory deficit in the ophthalmic division of the trigeminal nerve, and diplopia. Computed tomography demonstrated displaced bony fragments adjacent to the superior orbital fissure. Three-dimensional (3D) reconstruction was performed to precisely identify the compressive fragments. A patient-specific 3D-printed model was fabricated, allowing preoperative simulation of the surgical approach and osteotomy trajectory, as well as selection of appropriate instruments. Surgical decompression was performed on the tenth day after injury, resulting in complete recovery of extraocular movements within one month. This case highlights the value of 3D reconstruction and patient-specific physical model simulation in the diagnosis, surgical planning, and management of traumatic SOFS caused by direct bony compression. Patient-specific 3D planning may facilitate targeted and safe decompression in anatomically complex cases, and delayed surgical intervention may still result in favorable neurological recovery when persistent mechanical compression is clearly identified.