Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, OR, USA.
J Craniomaxillofac Surg. 2012 Feb;40(2):142-8. doi: 10.1016/j.jcms.2011.03.008. Epub 2011 Apr 13.
The outcomes of the reconstruction of post-ablative and post-traumatic orbital defects are often unpredictable when considering the restoration of the orbital dimensions. Intraoperative navigation offers the surgeon visualization of bony landmarks via comparison to preoperative computed tomography, aiding in bony reduction and implant placement. The purpose of this study was to assess whether intraoperative navigation-guided orbital reconstruction re-establishes orbital volume and globe projection in subjects with post-ablative and post-traumatic orbital defects.
The investigators initiated a retrospective cohort study and enrolled a sample of subjects that underwent primary or secondary reconstruction for unilateral orbital deformities secondary to traumatic injury or tumour surgery. Pre- and post-operative orbital volume and globe projection were measured using Analyze (Mayo Clinic Biomedical Imaging Resource, Rochester, MN, USA). A matched pairs t-test was used to assess the difference in pre- and post-operative orbital volume and globe projection.
Twenty-three subjects underwent intraoperative navigation-guided orbital reconstruction. The mean difference in orbital volume and globe projection between the non-operated orbit and operated orbit in the post-operative period was -1.3 cm(3) and 2.4mm respectively. Both final measurements were within the margin of error of clinically noticeable enophthalmos. The mean absolute difference in orbital volume and globe projection between the pre- and post-operative period was 5.1 cm(3) (p=<0.001) and 4.1mm (p=<0.001) respectively.
The results of this study suggest that orbital reconstruction using intraoperative navigation is effective in establishing normal orbital volume and globe projection in post-traumatic and post-ablative defects, therefore restoring the orbit and globe to pre-traumatic and pre-ablative conditions.
在考虑重建眼眶尺寸时，对于术后及创伤后眼眶缺损的重建结果往往难以预测。术中导航为外科医生提供了通过与术前 CT 比较来可视化骨标志的功能，有助于进行骨复位和植入物放置。本研究的目的是评估术中导航引导的眼眶重建术是否能恢复术后及创伤后眼眶缺损患者的眼眶容积和眼球突出度。
研究者开展了一项回顾性队列研究，纳入了一组因创伤或肿瘤手术而单侧眼眶畸形的患者，这些患者接受了原发性或继发性重建。使用 Analyze（美国明尼苏达州罗彻斯特市梅奥诊所生物医学成像资源）测量术前和术后眼眶容积和眼球突出度。采用配对 t 检验评估眼眶容积和眼球突出度的术前和术后差异。
23 例患者接受了术中导航引导的眼眶重建。术后非手术眼眶和手术眼眶的眶容积和眼球突出度的平均差值分别为-1.3cm³和 2.4mm。这两个最终测量值均在临床可察觉的眼球内陷的误差范围内。术前和术后眼眶容积和眼球突出度的平均绝对差值分别为 5.1cm³（p<0.001）和 4.1mm（p<0.001）。
本研究结果表明，术中导航引导的眼眶重建术在建立创伤后和术后眼眶缺损的正常眶容积和眼球突出度方面是有效的，从而使眼眶和眼球恢复到创伤前和术前状态。
