McNichols Colton H, Hatef Daniel A, Thornton James F, Cole Patrick D, de Mitchell C Alejandra Garcia, Hollier Larry H
Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA.
J Craniofac Surg. 2012 May;23(3):762-6. doi: 10.1097/SCS.0b013e31824dbda4.
Posttraumatic enophthalmos resulting from medial orbital wall fractures presents a complex challenge. Access to this area through traditional incisions is limited, making visualization of the fracture site difficult. This can be ameliorated by the transcaruncular approach, but with the potential for complications both with access and with reconstructive materials. The authors sought a new technique where enophthalmos correction would be based on augmenting soft tissue volume, rather than reducing the volume of the bony orbital cone. This was successfully accomplished using porous high-density polyethylene wedges. In an effort to increase overall knowledge of this technique, a retrospective review was undertaken.
A retrospective chart review was undertaken to examine the senior authors' (J.F.T. and L.H.H.) experience using a lateral approach to address medial orbital fracture-related enophthalmos, aided by porous high-density polyethylene wedges to increase orbital volume. The relevant literature was reviewed and reported here.
Three patients with post-medial orbital wall fracture enophthalmos were treated using a lateral approach to place porous high-density polyethylene wedges; this technique adequately corrected enophthalmos in these patients.
Porous high-density polyethylene wedges can be placed into the orbit through a small lateral incision to reverse enophthalmos secondary to loss of volume after medial orbital wall fractures. Current techniques for orbital reconstruction typically focus on reduction of bony volume; this technique focuses on augmentation of soft tissue volume.
眼眶内侧壁骨折导致的创伤后眼球内陷是一个复杂的挑战。通过传统切口进入该区域有限，使得骨折部位难以可视化。经泪阜入路可改善这一情况，但在进入和重建材料方面都有并发症的风险。作者寻求一种新技术，即眼球内陷的矫正基于增加软组织体积，而非减少眼眶骨锥的体积。使用多孔高密度聚乙烯楔形物成功实现了这一点。为了增加对该技术的总体了解，进行了一项回顾性研究。
进行回顾性病历审查，以检查资深作者（J.F.T.和L.H.H.）使用外侧入路处理眼眶内侧骨折相关眼球内陷的经验，借助多孔高密度聚乙烯楔形物增加眼眶容积。在此回顾并报告相关文献。
3例眼眶内侧壁骨折后眼球内陷患者采用外侧入路放置多孔高密度聚乙烯楔形物进行治疗；该技术充分矫正了这些患者的眼球内陷。
多孔高密度聚乙烯楔形物可通过外侧小切口置入眼眶，以矫正眼眶内侧壁骨折后因容积丧失继发的眼球内陷。目前的眼眶重建技术通常侧重于减少骨容积；该技术侧重于增加软组织容积。
