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羊膜和口腔黏膜移植治疗拔牙窝挛缩的临床及印片细胞学检查结果

Clinical and impression cytology findings of amniotic membrane and oral mucosal membrane transplantation for the management of socket contracture.

作者信息

Kurtul Bengi Ece, Erdener Ugur, Mocan Mehmet Cem, Irkec Murat, Orhan Mehmet

机构信息

Department of Ophthalmology, Hacettepe University, Ankara 06100, Turkey.

出版信息

Int J Ophthalmol. 2014 Apr 18;7(2):340-4. doi: 10.3980/j.issn.2222-3959.2014.02.27. eCollection 2014.

Abstract

AIM

To investigate and compare the cytopathological and clinical effects of amniotic membrane transplantation (AMT) and oral mucosal membrane transplantation (OMMT) in socket contraction.

METHODS

Twelve patients who could not be fitted with ocular prosthesis due to socket contracture were included in this study. Seven patients underwent AMT and 5 patients underwent OMMT. Thirteen patients who had healthy sockets were included as control group. Depth of inferior fornix, degree of inflammation, extent of the socket contracture and socket volume were measured in the preoperative period and at sixth and twelfth weeks postoperatively. Impression cytology of conjunctival fornices and tear transforming growth factor beta-1 (TGFβ1) levels were determined.

RESULTS

In the AMT group, socket volume and lower fornix depth values were significantly higher (P=0.030 and P=0.004 respectively) and inflammation levels and impression cytology stages (P=0.037 and P=0.022 respectively) were significantly lower in postoperative period compared to preoperative period. In the OMMT group, no statistical differences were found in terms of clinical parameters, inflammation levels and impression cytology stages of preoperative versus postoperative values. Preoperative tear TGFβ1 levels were higher in AMT and OMMT groups compared to the control group (25.5 ng/mL, 26.3 ng/mL and 21.7 ng/mL respectively). Decreased tear TGFβ1 levels were observed in both the AMT and OMMT groups postoperatively (median decrease value=2.1 ng/mL and 2.7 ng/mL respectively).

CONCLUSION

AMT is associated with postoperative improvement in inferior fornix depth, socket volume, inflammation and impression cytology levels and may be a more proper alternative method than OMMT in the management of socket contracture.

摘要

目的

研究并比较羊膜移植(AMT)和口腔黏膜移植(OMMT)在眼窝收缩方面的细胞病理学和临床效果。

方法

本研究纳入12例因眼窝挛缩无法佩戴义眼的患者。其中7例患者接受了AMT,5例患者接受了OMMT。另外纳入13例眼窝健康的患者作为对照组。在术前以及术后第6周和第12周测量下穹窿深度、炎症程度、眼窝挛缩范围和眼窝容积。测定结膜穹窿的印迹细胞学检查结果以及泪液转化生长因子β1(TGFβ1)水平。

结果

与术前相比,AMT组术后眼窝容积和下穹窿深度值显著更高(分别为P = 0.030和P = 0.004),炎症水平和印迹细胞学分期显著更低(分别为P = 0.037和P = 0.022)。在OMMT组,术前与术后的临床参数、炎症水平和印迹细胞学分期方面未发现统计学差异。与对照组相比,AMT组和OMMT组术前泪液TGFβ1水平更高(分别为25.5 ng/mL、26.3 ng/mL和21.7 ng/mL)。术后AMT组和OMMT组均观察到泪液TGFβ1水平下降(中位下降值分别为2.1 ng/mL和2.7 ng/mL)。

结论

AMT与术后下穹窿深度、眼窝容积、炎症和印迹细胞学水平的改善相关,在眼窝挛缩的治疗中可能是比OMMT更合适的替代方法。

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本文引用的文献

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Oral mucosal grafts: old technique in new light.口腔黏膜移植术:旧技术焕发新光彩。
Ophthalmic Res. 2013;50(2):91-8. doi: 10.1159/000351631. Epub 2013 Jul 3.
2
Amniotic membrane in the management of strabismus reoperations.羊膜在斜视再手术中的应用。
Jpn J Ophthalmol. 2013 Mar;57(2):239-44. doi: 10.1007/s10384-012-0217-5. Epub 2012 Dec 13.
3
Surgical management of acquired socket contracture.后天性牙槽窝挛缩的手术治疗
Curr Opin Ophthalmol. 2009 Sep;20(5):406-11. doi: 10.1097/ICU.0b013e32832ed85b.
6
Evaluation of amniotic membrane grafting in the reconstruction of contracted socket.羊膜移植用于收缩性牙槽窝重建的评估
Ophthalmic Plast Reconstr Surg. 2006 Mar-Apr;22(2):116-20. doi: 10.1097/01.iop.0000200887.26015.d4.
7
Reconstruction of contracted eye socket with amniotic membrane graft.羊膜移植修复睑球粘连性眼窝
Ophthalmic Plast Reconstr Surg. 2005 Sep;21(5):359-62. doi: 10.1097/01.iop.0000179378.97762.c7.
9
Impression cytology of the ocular surface: a review.眼表印片细胞学检查:综述
Exp Eye Res. 2004 Mar;78(3):457-72. doi: 10.1016/j.exer.2003.09.009.
10
Ocular surface impression cytology.眼表印迹细胞学
Adv Anat Pathol. 2003 Nov;10(6):328-37. doi: 10.1097/00125480-200311000-00003.

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