Knöringer P
Department of Neurosurgery, University of Ulm, Günzburg, West Germany.
Neurosurg Rev. 1989;12(1):31-9. doi: 10.1007/BF01787124.
In the treatment of fronto-basal cerebrocranial trauma and primary or secondary orbital tumors, definitive surgical intervention in one sitting has proven very successful. The orbital roof, the lateral orbital walls, and the frontal base are reconstructed with a bone meal/fibrin sealant plastic, whereas the orbital rims are revised using available bone fragments refitted using osteosynthetic procedures. Remaining calotte defects are covered alloplastically with Refobacin-Palacos. Bones can be easily remodeled with the bone meal/fibrin sealant plastic. The fibrin sealant holds the shape in regions not subject to mechanical stress, and contributes to an immediate, watertight closure. The addition of an antibiotic achieves effective prophylaxis against infections in the initial phase. The result is an autologous bone which provides a maximum of protection against late infections such as occur in alloplasties and against ascending infections with meningitis, as observed in unreconstructed bone defects. Since the bone meal is usually obtained during trepanation, bone biopsies of other body regions are unnecessary.
在治疗额底部颅脑创伤以及原发性或继发性眼眶肿瘤时，一次性确定性手术干预已被证明非常成功。使用骨粉/纤维蛋白密封剂塑料重建眶顶、眶外侧壁和额底部，而使用通过骨合成程序重新装配的可用骨碎片修复眶缘。剩余的颅骨缺损用雷佛霉素 - 帕拉科斯进行异体植入覆盖。骨粉/纤维蛋白密封剂塑料可轻松重塑骨骼。纤维蛋白密封剂在不受机械应力的区域保持形状，并有助于立即实现水密性闭合。添加抗生素可在初始阶段有效预防感染。结果是形成自体骨，可最大程度地预防诸如异体植入时发生的晚期感染以及未重建骨缺损时出现的脑膜炎上行感染。由于骨粉通常在环钻术期间获取，因此无需对身体其他部位进行骨活检。
