Mu Xiongzheng, Zhang Ruhong, Wei Min, Wang Yimin, Ding Meixiu, Zhang Disheng, Mao Qin, Feng Shengzhi
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Second Medical University, Shanghai, China.
J Craniofac Surg. 2005 Jan;16(1):144-9. doi: 10.1097/00001665-200501000-00029.
For dealing with the problems in orbital and periorbital deformities.
In orbital deformities such as hypertelorism, orbital dystopia, radiated orbit, and secondary deformities of traumatic orbit, the authors used lamella osteotomies of either orbital rim and wall or complex osteotomies in both adjacent orbital rims and walls with bicoronal incision and galea aponeurotica dissection. In most of the cases, the fragments of complex osteotomies were repositioned with rigid fixation.
Best results with nearly normal orbital volumes, better contour of orbit and midface, and improved eyelids and vision were achieved in 44 cases. There were 5 cases of supraorbital osteotomy (intracranial routine), 8 cases of medial orbital osteotomy, 3 cases of inferior orbital osteotomy, and 28 cases of both lateral and inferior orbital osteotomy in the series. No complications occurred. Clinical measurement was achieved in both pre- and postoperative osteotomies. According to comparative recordings, such as cephalometric measurement of the interorbital distance, exophthalmic measurement with Hertel exophthalmometer, the angle between orbital horizontal level and bilateral tragus linkage, and the linear distance between lateral canthus and tragus, the gap difference between pre- and postoperative data were achieved. The orbital and midface appearance has improved significantly.
Lamella and complex osteotomies of orbital rim and wall were proved to be save and effective for correction of most deformities of the orbital and periorbital region.
处理眼眶及眶周畸形问题。
对于诸如眶距增宽症、眼眶异位、放射性眼眶以及外伤性眼眶继发畸形等眼眶畸形，作者采用眶缘和眶壁的分层截骨术，或在双侧相邻眶缘和眶壁进行复合截骨术，并采用双冠状切口及帽状腱膜下分离。在大多数病例中，复合截骨的骨块通过坚固固定进行重新定位。
44例患者取得了最佳效果，眼眶容积接近正常，眼眶和中面部轮廓更佳，眼睑及视力得到改善。该系列中有5例眶上截骨术（颅内常规手术），8例眶内侧截骨术，3例眶下截骨术，28例眶外侧和眶下联合截骨术。未发生并发症。术前及术后截骨均进行了临床测量。根据比较记录，如眶间距离的头影测量、使用Hertel眼球突出计进行的眼球突出测量、眼眶水平与双侧耳屏连线之间的夹角以及外眦与耳屏之间的直线距离，得出术前和术后数据的差值。眼眶及中面部外观有显著改善。
眶缘和眶壁的分层及复合截骨术被证明对于矫正眼眶及眶周区域的大多数畸形是安全有效的。
