Search Results (3)

Background: Digital surgery integrates advanced imaging, computational modeling, additive manufacturing, and intraoperative navigation technologies. Although widely explored, most platforms remain fragmented and lack regulatory cohesion. The B-onic Platform was conceived as a unified workflow that enables surgical planning, device personalization, and intraoperative navigation within a regulatory-compliant framework. Objective: This study aimed to present a comprehensive single-center clinical evaluation of the implementation of the B-onic Platform in a large single-center cohort, focusing on efficiency, patient safety, and surgeon-reported outcomes. Methods: A retrospective review of 308 consecutive surgical plans was performed at La Paz University Hospital (Madrid, Spain) between 2020 and 2024 and compared with institutional historical controls from 2018 to 2019. Procedures included maxillofacial surgery, traumatology, reconstructive surgery, and other specialties. The platform incorporated imaging-based CAD modeling, 3D-printed biomodels and guides, and immersive validation through the NavigatorPro XR module. Outcomes analyzed were preoperative planning time, operative duration, 30-day complication and rehospitalization rates, intraoperative blood loss, and surgeon-reported perception of anatomical understanding and intraoperative confidence. Results: Mean preoperative planning time was reduced by 34% (−42 h; 95% CI: −48 to −36 h; p < 0.01) compared with historical controls. Mean operative duration decreased from 226 ± 74 min to 181 ± 61 min (−45 min; 95% CI: −52 to −38 min; p < 0.001). The 30-day postoperative complication rate decreased from 12.9% to 10.7% (absolute reduction 2.2%; 95% CI: 0.2–4.1%; p = 0.037), while rehospitalization rates declined from 9.1% to 4.3% (p = 0.012). Mean length of hospital stay decreased from 6.8 ± 3.1 to 5.2 ± 2.3 days (p = 0.022), and intraoperative blood loss was reduced by 12–30% across specialties (p = 0.008). NavigatorPro XR halved validation time for guides and implants (71.8 ± 22.4 h vs. 35.6 ± 18.9 h; p < 0.001). Ninety-two percent of surveyed surgeons reported improved 3D anatomical understanding and enhanced intraoperative safety. Conclusions: The B-onic Platform has transitioned from a prototype to a consolidated system, integrated into routine practice with significant gains in efficiency, safety, and training value. These findings support the potential of the platform as a precision surgery model; however, further multicenter prospective studies are required to confirm scalability. Full article

Background/Objectives: Frontal sinus fractures are uncommon injuries that may cause persistent aesthetic deformity when the anterior wall is comminuted, as small irregular fragments are difficult to stabilize with conventional osteosynthesis alone. Methods: We describe a point-of-care digital workflow combining 3D planning/printing and cyanoacrylate-assisted fixation for an isolated comminuted anterior frontal sinus wall fracture. A young adult presented with a depressed forehead contour after assault; computed tomography confirmed at least four displaced fragments. Results: A two-part 3D-printed biomodel was manufactured in-house to visualize the defect and guide extracorporeal reconstruction. Through a coronal approach, fragments were mobilized and anatomically reassembled using the biomodel as a reference; sinonasal drainage was preserved and sinus obliteration was not required. Because fragment size and geometry limited screw purchase, a modified N-butyl-2-cyanoacrylate adhesive (Glubran 2) was applied as an adjunct to maintain reduction, followed by reinforcement with titanium microplates. Postoperative recovery was uneventful, with immediate restoration of forehead contour and no early complications; postoperative imaging confirmed satisfactory alignment. Conclusions: This case supports the feasibility of integrating point-of-care 3D biomodeling with cyanoacrylate as a coadjuvant to microplate fixation in selected comminuted frontal sinus fractures to enhance fragment handling and contour restoration. Full article

Background/Objectives: Pediatric orbital tumors are rare and complex, requiring multidisciplinary care at specialized centers. Contemporary treatment paradigms emphasize centralized care delivery through experienced multidisciplinary teams to optimize patient outcomes. Recent advances in surgical planning technologies and intraoperative navigation systems have substantially enhanced surgical safety through improvement in tumor resection and reconstruction and reduction in complications, including recurrence of the lesion. Computed-aided surgical technologies enable precise virtual planning, minimally invasive approaches and more precise reconstruction methods when necessary by mean of patient-specific cutting guides, premolded orbital plates or individual patient solutions (IPS) prosthesis. Three-dimensional biomodelling visualizes tumor architecture and aids localization while preserving neurovascular structures, and real-time neuronavigation improves safety and efficacy. Methods: We conducted a retrospective analysis of 98 pediatric patients with orbital tumors treated between 2014 and 2025 at a tertiary center to evaluate the use of computed-assisted surgical technologies and the indications for treatment. Inclusion criteria comprised all cases where computer-assisted techniques were employed. Patients were classified into two groups: Group 1—intraconal or extensive periorbital lesions with eye-sparing intent treated via craniofacial approaches; Group 2—periorbital tumors with orbital wall involvement, to analyze the use of the different technologies. Data collected included tumor age, type, location, technology used, adjunctive treatments, and postoperative outcomes. Results: Twelve patients underwent computer-assisted surgery. Technologies employed over the last six years included intraoperative navigation, 3D planning with/without tumor segmentation, orbital-wall reconstruction by mirroring, IPS or titanium mesh bending, and preoperative biomodelling. Patients were grouped by tumor location and treatment goals: Group 1—intraorbital lesions (primarily intraconal or 270–360° involvement), including one case of orbital encephalocele treated transcranially; Group 2—periorbital tumors with orbital-wall destruction, treated mainly via midfacial approaches. Intraoperative navigation was used in 10/12 cases (8/11 with tumor segmentation); in 3 cases with ill-defined margins, navigation localized residual tumor. Virtual surgery predominated in Group 2 (4 patients) and one in Group 1, combined with cutting guides for margins and Individual Prosthetic Solutions (IPS) prosthesis fitting (two patients: titanium and PEEK). In two cases, virtual plans were performed, STL models printed, and premolded titanium meshes used. No complications related to tumor persistence or orbital disturbance were observed. Conclusions: Advanced surgical technologies substantially enhance safety, efficiency, and outcomes in pediatric orbital tumors. Technology-assisted approaches represent a paradigm shift in this complex field. Additional studies are needed to establish evidence-based protocols for systematic integration of technology in pediatric orbital tumor management. Full article