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[眶颅纤维发育不良病变切除术及钛重建术]

[Resection of orbito-cranial fibrous dysplasia lesion and reconstruction with titanium].

作者信息

Xu Bei, Ma Jianrong, Yi Wenshu, Tan Jia, Xiang Qian, Xu Xueliang

机构信息

Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012 Mar;37(3):267-70. doi: 10.3969/j.issn.1672-7347.2012.03.010.

DOI:10.3969/j.issn.1672-7347.2012.03.010
PMID:22561495
Abstract

OBJECTIVE

To discuss the method and opportunity of operation for orbito-cranial fibrous dysplasia, and further to summarize our experience in repairing the bony defect with titanium after excision and assess the surgical outcomes.

METHODS

A retrospective study was performed in 21 patients with visual function damage and/ or orbital malformation, who treated surgically. All patients were underwent CT examinations (coronal, horizontal, sagittal and three-dimensional scans) before surgery. CT image data of patients with serious orbital skull lesions were analyzed by computer to produce the three-dimensional, solid titanium mesh prostheses used to repair the lesions; for smaller lesions solid titanium mesh prostheses were shaped artificially during surgery according to the normal orbit and the cranium. All the patients were treated surgically via craniofacial approach. After removing the diseased tissue, the defective area was repaired by titanium plate and nets.

RESULTS

Of the 21 patients, tumor removal was complete in 18 patients, and incomplete in 3 patients due to extensive invasion into the sious cavernosus. Of the 13 patients with vision impairment before surgery, vision was improved in 11 cases (range from 3 to 5 lines) following surgery. All orbital malformations were healed in these 11 patients.

CONCLUSION

Patients with fibrous dysplasia should undergo surgical treatment as soon as possible. Where this results in visual dysfunction or orbital-cranial deformities, repairing the bony defect with titanium material has many advantages: it is solid, easily molded, and easily fastened.

摘要

目的

探讨眶颅纤维发育不良的手术方法及时机,进一步总结切除术后用钛修复骨缺损的经验并评估手术效果。

方法

对21例因视觉功能损害和/或眼眶畸形接受手术治疗的患者进行回顾性研究。所有患者术前均接受CT检查(冠状位、水平位、矢状位及三维扫描)。对眼眶颅骨病变严重的患者的CT图像数据进行计算机分析,制作用于修复病变的三维实体钛网假体;对于较小的病变,在手术中根据正常眼眶和颅骨人工塑形实体钛网假体。所有患者均经颅面入路手术治疗。切除病变组织后,用钛板和钛网修复缺损区域。

结果

21例患者中,18例肿瘤切除完全,3例因广泛侵犯海绵窦切除不完全。术前有视力障碍的13例患者中,术后11例视力改善(提高3至5行)。这11例患者的眼眶畸形均得到矫正。

结论

纤维发育不良患者应尽早接受手术治疗。当出现视觉功能障碍或眶颅畸形时,用钛材料修复骨缺损有诸多优点:坚固、易于塑形且易于固定。

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