Intraoperative computed tomography for orbital reconstruction: a systematic review

Orbital reconstruction is a common procedure with inherent challenges and important consequences. Intraoperative use of computed tomography (CT) is an emerging application that facilitates accurate intraoperative evaluation to improve clinical outcomes. The aim of this review was to investigate the intraoperative and postoperative outcomes of intraoperative CT use in orbital reconstruction. The PubMed and Scopus databases were systematically searched. Inclusion criteria were clinical studies investigating intraoperative CT use in orbital reconstruction. Exclusion criteria were duplicates, non-English publications, non-full-text publications, and studies with insufficient data. Of the 1022 articles identified, seven eligible articles representing 256 cases were included. The mean age was 39 years. Most cases were male (69.9% male, 30.1% female). Regarding intraoperative outcomes, the mean revision rate was 34.1%, with plate repositioning being the most common type (51.1%). The intraoperative time was variably reported. With regards to postoperative outcomes, there were no revisions, and only one case had a complication (transient exophthalmos). The mean volumetric difference between the repaired and contralateral orbits was reported in two studies. The findings of this review present an updated evidence-based summary of the intraoperative and postoperative outcomes of intraoperative CT use in orbital reconstruction. Robust longitudinal comparisons of clinical outcomes between intraoperative and non-intraoperative CT cases are required.