Song Seung Han, Kyung Hyunwoo, Oh Sang-Ha, Kang Nakheon
From the *Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, Daejeon; †Okcheon-gun Health Center, Chungbuk; and ‡Clinical Anatomy Institute, Chungnam National University Hospital, Daejeon, South Korea.
J Craniofac Surg. 2014 May;25(3):919-21. doi: 10.1097/SCS.0000000000000663.
Zygomaticomaxillary complex (ZMC) fracture occurs commonly, and restorations of facial shape and symmetry by 3-dimensional reduction and ridged fixation are important. A severe ZMC fracture is accompanied by fractures to the anterior wall of maxillary sinus; thus, various complications can occur without appropriate restoration by surgery.
Of the patients with ZMC fracture from January 2008 to December 2012, 328 patients underwent surgery. Among them, 234 patients with severe fractures to the anterior wall of the maxillary sinus underwent restoration using fibrin glue (Tisseel; Baxter Healthcare, Norfolk, UK).
There were no major side effects in any of the 234 patients in whom Tisseel was used, and the bone fragments were fixed well in their original places according to postoperative CT findings.
Grafted bone fragments can be maintained in their original places by fibrin clot layers with Tisseel. Using Tisseel, operation time is reduced, and the bleeding tendency is decreased by reduced shearing force with surrounding tissues and the hemostatic reaction of fibrin. Therefore, it can be concluded that using Tisseel is one effective method for the restoration of fractures on the anterior wall of the maxillary sinus.
颧上颌复合体（ZMC）骨折常见，通过三维复位和坚固内固定恢复面部形态和对称性很重要。严重的ZMC骨折伴有上颌窦前壁骨折；因此，若不通过手术进行适当复位，可能会出现各种并发症。
2008年1月至2012年12月期间，328例ZMC骨折患者接受了手术。其中，234例上颌窦前壁严重骨折患者使用纤维蛋白胶（Tisseel；百特医疗保健公司，英国诺福克）进行复位。
使用Tisseel的234例患者中均未出现严重副作用，根据术后CT检查结果，骨碎片在原位固定良好。
Tisseel形成的纤维蛋白凝块层可将移植的骨碎片维持在原位。使用Tisseel可缩短手术时间，通过减少与周围组织的剪切力和纤维蛋白的止血反应降低出血倾向。因此，可以得出结论，使用Tisseel是上颌窦前壁骨折复位的一种有效方法。
