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Abstract
Backgraund: Midfacial defects involving the orbital region are among the most complex challenges in reconstructive surgery. Globally, the incidence of malignant orbital tumors—and subsequent orbital defects—is around 3.39 cases per million person-years. Due to anatomical and functional limitations, traditional microsurgical techniques cannot fully restore both function and aesthetics in this area. Aims: To enhance the quality of life in patients with midfacial defects using computer-assisted 3D planning for simultaneous extracranial implantation and silicone facial prostheses. Materials and methods: his retrospective study analyzed 63 patients (32 men, 31 women; aged 21–84) treated for midfacial defects at the National Medical Research Center of Otorhinolaryngology (FMBA of Russia) between 2007 and 2025. The etiologies included malignant neoplasms (n=5), post-resection defects after oncological surgeries (n=55), trauma (n=2), and inflammation (n=1). Surgical procedures included placement of cranial implants in the orbital region (n=60), use of a free fibular bone flap with cranial implants (n=2), combination of free fibular flap, free anterolateral thigh flap, and cranial implants (n=1). Patients underwent Magnetic Resonance Imaging (MRI), Multi-Slice Spiral Computed Tomography (MSCT), and 3D computer modeling (Amira and Blender) for pre- and postoperative planning. Outcomes were assessed using modified ECOG questionnaire,VHNSS 2.0,and Holger’s scale (PEQ).Data analysis was conducted using Excel and Statistica 8. Results: 3D modeling significantly improved implant accuracy and aesthetic outcomes (average patient satisfaction: 9/10). The cranial implant survival rate was 98%. Comparative analysis of VHNSS 2.0 and ECOG showed enhanced quality of life and aesthetic satisfaction post-rehabilitation. Holger’s scale confirmed usability and patient satisfaction with the prostheses. Conclusions: Computer-assisted 3D planning significantly improves surgical precision and aesthetic predictability in midface reconstruction. The integration of 3D technologies has enabled the simultaneous performance of surgical and prosthetic procedures, enhancing rehabilitation outcomes for patients with orbital defects.
