Yun Ji Young, Kang Seok Ju, Kim Jin Woo, Kim Young Hwan, Sun Hook
Department of Plastic and Reconstructive Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Arch Plast Surg. 2012 Jul;39(4):333-7. doi: 10.5999/aps.2012.39.4.333. Epub 2012 Jul 13.
Patients who have undergone enucleation during infancy due to retinoblastoma can develop microorbitalism due to the decreased growth stimulation from the eyeball and the surrounding soft tissues. Anatomically, the orbit consist of parts of the frontal bone superiorly, the maxilla inferiorly, the ethmoid bone medially, and the zygoma laterally. Considering the possibility of surgically expanding the orbit using tripod osteotomy, in this study we conducted tripod osteotomy on adult patients with microorbitalism of retinoblastoma.
Tripod osteotomy was conducted to expand the orbital volume in adult patients with microorbitalism due to enucleation in infancy for retinoblastoma. The orbital volume was measured using the Aquarius Workstation ver. 4.3.6 and the orbit width was measured with preoperative and postoperative 3-dimensional facial bone computed tomography (CT) imaging. Preoperative and postoperative photographs were used to visualize the difference produced by the surgery.
The orbital volume of the affected side was 10.3 cm(3) before and 12.5 cm(3) after the surgery, showing an average increase in volume of 2.2 cm(3) (21.4%). The increase in the obital width was confirmed by the preoperative and postoperative 3-dimensional facial CT images and aesthetic improvement was observed by the preoperative and postoperative photographs.
Tripod osteotomy, which realigns the orbital bone, zygoma, and maxilla, is used to correct posttraumatic malunion as well as non-traumatic congenital abnormalities such as that seen in facial cleft. We applied this procedure in microorbitalism secondary to enucleation for retinoblastoma to allow orbital expansion and correct asymmetry.
因视网膜母细胞瘤在婴儿期接受眼球摘除术的患者，由于眼球及周围软组织生长刺激减少，可能会出现小眼眶畸形。从解剖学上讲，眼眶由上方的额骨、下方的上颌骨、内侧的筛骨和外侧的颧骨部分组成。考虑到使用三脚架截骨术手术扩大眼眶的可能性，在本研究中，我们对患有视网膜母细胞瘤所致小眼眶畸形的成年患者进行了三脚架截骨术。
对因婴儿期视网膜母细胞瘤眼球摘除术导致小眼眶畸形的成年患者进行三脚架截骨术以扩大眼眶容积。使用Aquarius Workstation ver. 4.3.6测量眼眶容积，并用术前和术后的三维面部骨计算机断层扫描（CT）成像测量眼眶宽度。术前和术后照片用于直观显示手术产生的差异。
患侧眼眶容积术前为10.3 cm³，术后为12.5 cm³，平均容积增加2.2 cm³（21.4%）。术前和术后的三维面部CT图像证实了眼眶宽度的增加，术前和术后照片观察到美学改善。
三脚架截骨术可重新调整眼眶骨、颧骨和上颌骨的位置，用于矫正创伤后骨不连以及非创伤性先天性异常，如面部裂所见。我们将此手术应用于视网膜母细胞瘤眼球摘除术后继发的小眼眶畸形，以实现眼眶扩大并矫正不对称。
