He Yang, Zhang Yi, An Jin-gang
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2011 Oct 18;43(5):761-5.
To assess the vascularization of the laterally based pericranial flap and the feasibility of bony channel on the orbital lateral wall for transplantation of the flap, and apply this flap to treat traumatic enophthalmos.
Two formalin preserved cadaver specimens were anatomized to observe the feasibility of pericranial flap transplantation through the bony channels on lateral orbital walls. Two fresh cadaver specimens were perfused with latex and ink respectively to observe the possible blood supply to laterally based pericranial flaps. Two patients with unilateral old orbital fracture were treated using this flap. The enophthalmos degrees were measured before and after operation to evaluate the effect of this therapy.
It was feasible to transplant the pericranial flap into orbit through the bony channel on lateral orbital wall, reaching the medial wall and orbital floor. Vascular perfusion did not reveal that the laterally based pericranial flap over the supra temporal line was vascularized by any axial vessel. The ink perfusion of one side showed that the middle temporal artery extended deeply under the deep temporal fascia, but didn't cross the supra temporal line. The subgaleal vascular plexus was observed obviously in the superficial layer of pericranial flap. The enophthalmos degrees of the two patients were respectively 5.35 mm and 6.86 mm prior to operation. They both showed desirable outcomes postoperation (<2 mm).
It is feasible to transfer the laterally based pericranial flap into orbit through the lateral orbital wall channel. The laterally based pericranial flap is possibly vascularized by the subgaleal vascular plexus. The primary treatment of traumatic enophthalmos using the laterally based pericranial flap is satisfactory.
评估颞部带蒂颅骨膜瓣的血管化情况以及眶外侧壁骨通道用于该瓣移植的可行性，并应用此瓣治疗外伤性眼球内陷。
解剖两具经福尔马林固定的尸体标本，观察颅骨膜瓣经眶外侧壁骨通道移植的可行性。分别对两具新鲜尸体标本进行乳胶和墨水灌注，观察颞部带蒂颅骨膜瓣的可能血供情况。使用此瓣治疗2例单侧陈旧性眼眶骨折患者。测量手术前后的眼球内陷度数，以评估该治疗方法的效果。
颅骨膜瓣经眶外侧壁骨通道移植至眼眶，到达内侧壁和眶底是可行的。血管灌注未显示颞上线以上的颞部带蒂颅骨膜瓣由任何轴型血管供血。一侧的墨水灌注显示颞中动脉在颞深筋膜深层深面走行，但未越过颞上线。在颅骨膜瓣浅层可见明显的帽状腱膜下血管丛。两名患者术前的眼球内陷度数分别为5.35 mm和6.86 mm。术后均显示出理想的效果（<2 mm）。
颞部带蒂颅骨膜瓣经眶外侧壁通道转移至眼眶是可行的。颞部带蒂颅骨膜瓣可能由帽状腱膜下血管丛供血。应用颞部带蒂颅骨膜瓣初步治疗外伤性眼球内陷效果满意。
