Lauer Günter, Pradel Winnie, Schneider Matthias, Eckelt Uwe
Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
Mund Kiefer Gesichtschir. 2006 Sep;10(5):325-9. doi: 10.1007/s10006-006-0016-6.
Aim of this retrospective study was to assess the outcome after secondary midfacial reconstruction using different operation techniques and computer assisted surgery. Functional and aesthetic aspects as well as experiences are reported.
18 patients were assessed for enophthalmos, diplopia, and aesthetics during a follow-up period of up to 2.5 years.
In 40% of the patients several techniques for soft and hard tissue reconstruction were used. In 5 of the 9 patients diplopia was improved; in 4 patients there was no change. A significant enophthalmos was corrected in 8 out of 12 patients. After additional surgery 6 patients had a good aesthetic result, 7 a satisfactory and 5 a poor.
For secondary midfacial reconstruction often a combination of different surgical techniques is necessary. Bony asymmetries and enophthalmos were successfully corrected, however, functional and aesthetic impairment due to bad soft tissue condition are difficult to correct. Computer assisted surgery is helpful for dissection within the orbit, for graft placement, and for positioning of osteotomized segments.
本回顾性研究旨在评估采用不同手术技术和计算机辅助手术进行二期面中部重建后的效果。报告了功能和美学方面以及相关经验。
在长达2.5年的随访期内，对18例患者的眼球内陷、复视和美观情况进行了评估。
40%的患者使用了多种软组织和硬组织重建技术。9例患者中有5例复视情况得到改善；4例患者无变化。12例患者中有8例显著的眼球内陷得到矫正。二次手术后，6例患者获得良好美学效果，7例满意，5例效果不佳。
二期面中部重建通常需要多种手术技术联合应用。骨不对称和眼球内陷得到成功矫正，然而，由于软组织条件差导致的功能和美学损害难以矫正。计算机辅助手术有助于眼眶内解剖、植骨放置以及截骨段定位。
