预成形钛网在眼眶骨折眶壁修复中的应用
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摘要
目的评价预成形钛网在眼眶骨折眶壁修复重建中的应用效果。方法 2012年1月1日～7月30日在解放军总医院眼科就诊并接受治疗的眼眶骨折病例27例,该组病例术前均存在眼球内陷、眶壁缺损、骨性眶腔扩大和眶内软组织疝出。术前常规行眼眶水平、冠状位及三维CT检查,应用预成形钛网行眶壁修复重建,术后继续CT检查,以评价眼眶骨折后眶壁重建的准确性和眼球突出度恢复情况。结果术后3月随访,所有病例都成功地实施了眼眶壁的重建,术中术后均未发生严重并发症,85.2%(23/27)的患者眼球内陷矫正在3 mm内。结论应用预成形钛网可比较精确地修复眶壁骨折。
Objective To assess the effect of preformed orbital titanium mesh in the reconstruction of orbital fracture. Method Twenty-seven cases of blow-out orbital fracture were diagnosed in the period from January 2012 to July 2012, all with serious defect of the orbital wall and herniation of the orbital soft tissues. Preformed orbital titanium mesh was grafted to the traumatic orbital walls. Orbital axial and coronal CT and three-dimension CT scan examination were performed routinely in all cases preoperatively and postoperatively to evaluate the postoperative exophthalmos and orbital wall reconstruction. Results All the patients were followed up for 3 months. Orbital wall reconstruction was successfully performed in all cases without serious complications. The postoperative enophthalmos was less than 3 mm in 23 of the 27 cases. Conclusion Preformed orbital titanium mesh allows accurate reconstruction of orbital wall fracture.
Objective To assess the effect of preformed orbital titanium mesh in the reconstruction of orbital fracture. Method Twenty-seven cases of blow-out orbital fracture were diagnosed in the period from January 2012 to July 2012, all with serious defect of the orbital wall and herniation of the orbital soft tissues. Preformed orbital titanium mesh was grafted to the traumatic orbital walls. Orbital axial and coronal CT and three-dimension CT scan examination were performed routinely in all cases preoperatively and postoperatively to evaluate the postoperative exophthalmos and orbital wall reconstruction. Results All the patients were followed up for 3 months. Orbital wall reconstruction was successfully performed in all cases without serious complications. The postoperative enophthalmos was less than 3 mm in 23 of the 27 cases. Conclusion Preformed orbital titanium mesh allows accurate reconstruction of orbital wall fracture.
引文
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[16]吴雄辉,孙虹,邢晓为,等.纳米羟基磷灰石表面修饰及其DNA结合性能的实验研究[J].南方医科大学学报,2010,30(10):2233-6,2241.
[17]Folkestad L,Granstr m G.A prospective study of orbital fracturesequelae after change of surgical routines[J].J Oral MaxillofacSurg,2003,61(9):1038-44.
[18]张智勇,张益,贺洋,等.单侧眼眶骨折眼球突度的CT测量方法与可靠性评价[J].中华整形外科杂志,2009,25(3):169-72.
[19]王燕,华泽权.眼眶骨折重建和眼球内陷矫治的现状与展望[J].现代口腔医学杂志,2012,26(1):59-62.
[20]毕晓萍,范先群,施沃栋,等.三维眶底重建钛网在复合性眼眶骨折中的应用[J].中华眼科杂志,2011,47(8):683-7.
[21]宋国祥.眼眶病学[M].2版:北京人民卫生出版社,2010:457-73.
[2]Scolozzi P,Momjian A,Heuberger J,et al.Accuracy andpredictability in use of AO three-dimensionally preformed Titaniummesh plates for posttraumatic orbital reconstruction:a pilot study[J].J Craniofac Surg,2009,20(4):1108-13.
[3]范先群.眼整形外科学[M].北京:北京科学技术出版社,2009:606-10.
[4]贺洋,张益,张智勇.眼眶骨折标准诊断CT层面的确定与应用研究[J].实用口腔医学杂志,2009,25(3):385-9.
[5]Hintschich C.Periocular plastic surgery[J].Dtsch Arztebl Int,2010,107(10):141-6.
[6]范先群.眼眶骨折整复手术的现状和问题[J].眼科,2005,14(6):357-9.
[7]张益.眼眶骨折的重建和眼球内陷的外科矫治[J].北京口腔医学,2008,16(6):301-3.
[8]Metzger MC,Sch n R,Schulze D,et al.Individual preformedtitanium meshes for orbital fractures[J].Oral Surg Oral Med OralPathol Oral Radiol Endod,2006,102(4):442-7.
[9]Shama V,Benger R,Martin PA.Challenges associated withregeneration of orbital floor bone[J].Tissue Eng Part B Rev,2010,16(2):541-50.
[10]Al-Sukhun J,Kontio R,Lindqvist C,et al.Use of a prefabricatedtitanium plate for accurate reconstruction of secondary orbital blow-out fracture[J].Plast Reconstr Surg,2006,117(5):1648-51.
[11]张智勇,安金刚,贺洋,等.预成钛网在伴发眼球破裂眼眶骨折眶壁重建中的应用[J].实用口腔医学杂志,2011,27(1):38-41.
[12]Knott PT,Mardjetko SM,Kim RH,et al.A comparison of magneticand radiographic imaging artifact after using three types of metalrods:stainless steel,Titanium,and vitallium[J].Spine J,2010,10(9):789-94.
[13]Potter JK,Malmquist M,Ellis E.Biomaterials for Reconstructionof the internal orbi[t J].Oral Maxillofac Surg,2012,24(4):609-27.
[14]张宇,尹庆水,张余,等.载银珊瑚羟基磷灰石的载银量及其细胞相容性的实验研究[J].南方医科大学学报,2011,31(8):1411-5.
[15]Kelly CP,Cohen AJ,Yavuzer R,et al.Cranial bone grafting fororbital Reconstruction:is it still the best[J]?J Craniofac Surg,2005,16(1):181-5.
[16]吴雄辉,孙虹,邢晓为,等.纳米羟基磷灰石表面修饰及其DNA结合性能的实验研究[J].南方医科大学学报,2010,30(10):2233-6,2241.
[17]Folkestad L,Granstr m G.A prospective study of orbital fracturesequelae after change of surgical routines[J].J Oral MaxillofacSurg,2003,61(9):1038-44.
[18]张智勇,张益,贺洋,等.单侧眼眶骨折眼球突度的CT测量方法与可靠性评价[J].中华整形外科杂志,2009,25(3):169-72.
[19]王燕,华泽权.眼眶骨折重建和眼球内陷矫治的现状与展望[J].现代口腔医学杂志,2012,26(1):59-62.
[20]毕晓萍,范先群,施沃栋,等.三维眶底重建钛网在复合性眼眶骨折中的应用[J].中华眼科杂志,2011,47(8):683-7.
[21]宋国祥.眼眶病学[M].2版:北京人民卫生出版社,2010:457-73.