Cakir Beyhan, Aygit Ahmet Cemal, Omur-Okten Ozerk, Yalcin Omer
Department of Plastic, Reconstructive and Aesthetic Surgery, Trakya University Medical Faculty, Edirne, Turkey.
J Oral Maxillofac Surg. 2012 Jan;70(1):242-50. doi: 10.1016/j.joms.2011.02.091. Epub 2011 Jul 16.
Despite adequate treatment, enophthalmos due to intraconjunctival corticosteroid injection and enlargement of the bony orbit after trauma remains a frequent complication. The use of alloplastic material in addressing this problem is restricted because it may result in allergic reactions and is not cost-effective. The use of retro-orbital intraconal injection is the most effective method for maximum augmentation. An inexpensive and minimally invasive alternative that also allows for reoperation when needed would be a preferred intervention.
We used 24 white rabbits (New Zealand) in our study. The animals were divided into 2 groups: a fat group and a saline solution group. The first group was subjected to retrobulbar fat injection, and the second group underwent physiologic saline solution injection. The volume of the retrobulbar area was measured and statistically evaluated both before and after the injections. Sonographically measured retrobulbar volumes were then statistically analyzed.
When the saline solution and fat groups were compared, no significant difference was observed between the preinjection volumes of the orbits. However, after injection, there was a significant difference between volumes. A statistically significant difference was shown between retro-orbital volumes calculated before the injection in the fat group and volumes calculated immediately after injection and in the following 4 months (right retro-orbital volume of 1.291 cm(3) ± 0.031 cm(3) before injection and 2.656 cm(3) ± 0.040 cm(3) in the fourth month, P < .05).
Volume augmentation by fat injection is superior to complicated surgical methods because of the advantages of decreased morbidity, rapid rehabilitation, and ease of reinjection. Using fat tissue as a filling material is more reliable, easier, and cheaper in comparison to other implantable materials.
尽管进行了充分治疗，但结膜下注射皮质类固醇导致的眼球内陷以及外伤后眼眶骨增大仍是常见并发症。使用异体材料解决此问题受到限制，因为可能会引起过敏反应且不具有成本效益。眶后锥内注射是实现最大程度增大的最有效方法。一种廉价且微创的替代方法，并且在需要时还能再次手术，将是首选的干预措施。
我们在研究中使用了24只（新西兰）白兔。动物被分为两组：脂肪组和盐溶液组。第一组接受球后脂肪注射，第二组接受生理盐溶液注射。在注射前后测量并对球后区域的体积进行统计学评估。然后对超声测量的球后体积进行统计学分析。
比较盐溶液组和脂肪组时，注射前眼眶体积之间未观察到显著差异。然而，注射后，体积之间存在显著差异。脂肪组注射前计算的眶后体积与注射后立即以及接下来4个月计算的体积之间显示出统计学上的显著差异（注射前右眶后体积为1.291 cm³±0.031 cm³，第四个月为2.656 cm³±0.040 cm³，P<.05）。
由于发病率降低、康复快和再次注射容易等优点，脂肪注射增大体积优于复杂的手术方法。与其他可植入材料相比，使用脂肪组织作为填充材料更可靠、更容易且更便宜。
