Dynamic surgical navigation in the reconstruction of complex orbital fractures: A literature review on the correction of enophthalmos and orbital volume

Resumo

Complex orbital fractures place a premium on accurate three-dimensional reconstruction, because even small residual discrepancies in bony orbital volume translate into measurable globe malposition. Persistent enophthalmos, vertical dystopia, and diplopia remain among the most disabling sequelae of inadequately treated fractures, and conventional freehand repair—constrained by a narrow surgical field and the absence of real-time feedback—has a documented ceiling on achievable precision. Over the past two decades, intraoperative computer-assisted surgical navigation, adapted from neurosurgical and otolaryngological stereotaxy, has been progressively incorporated into craniomaxillofacial trauma surgery to translate virtual preoperative planning into reproducible intraoperative execution. This narrative review synthesizes the anatomical rationale, surgical workflow, and accumulated clinical evidence supporting dynamic navigation in the reconstruction of complex orbital fractures, with emphasis on its measurable effect on orbital volume restoration and enophthalmos correction. A non-systematic search of PubMed, Scopus, and Google Scholar (2002–2026) was conducted using combinations of the terms “orbital fracture,” “navigation,” “enophthalmos,” “orbital volume,” and “virtual surgical planning.” The reviewed literature, spanning early observational cohorts to recent systematic reviews and meta-analyses, indicates that navigation-assisted reconstruction—used alone or combined with patient-specific implants—consistently improves volumetric accuracy and globe-position restoration relative to freehand surgery, although high-quality randomized evidence, standardized outcome metrics, and cost-effectiveness data remain comparatively scarce.