Wu Guo-ping, Teng Li, Gui Lai, Zhang Zhi-yong, Lü Chang-sheng, Niu Feng, Xia De-lin, Luo Jin-chao, Liu Jian-feng
Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100041, China.
Zhonghua Yan Ke Za Zhi. 2004 Dec;40(12):800-3.
To explore the surgical approaches to obtain good aesthetic and functional results in the management of orbital and periorbital fibrous dysplasia and related deformities.
Ten cases of orbital and periorbital fibrous dysplasia were treated surgically. The location, extension and shape of the lesions were identified based on X-ray examination and two and three dimensions CT examinations preoperatively. According to the type of the lesion, different approaches were used to excise the lesion and to reconstruct the orbit. The lesions were radically or partially excised through bicoronal, intraoral and subciliary approach; the orbit was reconstructed with autogenous outer or inner table of calvarium, outer table of mandible, Medpor and prefabricated individual titanic implants.
In 10 cases treated surgically, radical excision was employed in 4 cases and partial excision in 6 cases. Autogenous inner table of calvarium was used in 2 cases, Medpor in 2 cases, outer table of mandible in 1 case, and titanic meshwork and prefabricated individual titanic implants in 4 cases to reconstruct the orbit. After the treatment, all patients obtained satisfactory aesthetic and functional results.
Carefully planed surgical approaches with methods for preventing the complications can be used for the treatment of orbital and periorbital fibrous dysplasia and obtaining satisfactory aesthetic and functional results.
探讨手术治疗眼眶及眶周纤维性发育异常及相关畸形以获得良好美学和功能效果的方法。
对10例眼眶及眶周纤维性发育异常患者进行手术治疗。术前通过X线检查及二维、三维CT检查确定病变的位置、范围及形态。根据病变类型,采用不同方法切除病变并重建眼眶。通过双冠状切口、口内切口及睫毛下切口对病变进行根治性或部分切除;采用自体颅骨外板或内板、下颌骨外板、Medpor及个体化定制钛植入物重建眼眶。
10例手术治疗患者中,4例行根治性切除,6例行部分切除。2例采用自体颅骨内板,2例采用Medpor,1例采用下颌骨外板,4例采用钛网及个体化定制钛植入物重建眼眶。治疗后,所有患者均获得满意的美学和功能效果。
精心规划的手术方法及预防并发症的措施可用于治疗眼眶及眶周纤维性发育异常,并获得满意的美学和功能效果。