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共聚物聚乳酸和聚乙醇酸可吸收板在眶底骨折修复中的应用。

Use of copolymer polylactic and polyglycolic acid resorbable plates in repair of orbital floor fractures.

作者信息

Lin Jonathan, German Michael, Wong Brian

机构信息

Department of Otolaryngology-Head and Neck Surgery, Irvine School of Medicine, University of California, Irvine, California.

Department of Otolaryngology-Head and Neck Surgery, Central Coast Head and Neck Surgeons, St. Monterey, California.

出版信息

Facial Plast Surg. 2014 Oct;30(5):581-6. doi: 10.1055/s-0034-1393697. Epub 2014 Nov 14.

Abstract

The fractures of the orbital floor are common after craniofacial trauma. Repair with resorbable plates is a viable reconstructive option; however, there are few reports in the literature. This study describes our experience using copolymer polylactic and polyglycolic acid (PLLA/PGA) orbital reconstruction plates (LactoSorb, Lorenz Surgical, Jacksonville, FL) in 29 cases of the orbital floor fracture repair. We conducted a retrospective review of 29 orbital floor fractures at a single institution repaired through transconjunctival, preseptal dissection using PLLA/PGA plates fashioned to repair the orbital floor defect. Associated fractures included zygomaticomaxillary, LeFort, and nasoethmoid fractures. There were six patients with complications. Four patients had transient diplopia with complete resolution of symptoms within 1 year. One patient had diplopia postoperatively, but was later lost to follow-up. Two patients have had persistent enophthalmos since 1 year. In each of these cases, the floor fracture was coincident with significant panfacial or neurotrauma. We did not encounter any adverse inflammatory reactions to the implant material itself. The study concluded that orbital floor fracture repair with resorbable plates is safe, relatively easy to perform, and in the majority of cases was effective without complications. In the presence of severe orbital trauma, more rigid implant materials may be appropriate.

摘要

颅面外伤后眶底骨折很常见。使用可吸收板进行修复是一种可行的重建选择;然而,文献中报道较少。本研究描述了我们在29例眶底骨折修复中使用共聚聚乳酸和聚乙醇酸(PLLA/PGA)眶重建板(LactoSorb,Lorenz Surgical,杰克逊维尔,佛罗里达州)的经验。我们对单一机构通过经结膜、眶隔前解剖使用PLLA/PGA板修复眶底缺损的29例眶底骨折进行了回顾性研究。相关骨折包括颧上颌、LeFort和鼻筛骨折。有6例患者出现并发症。4例患者出现短暂复视,症状在1年内完全缓解。1例患者术后出现复视,但后来失访。2例患者自1年以来一直存在眼球内陷。在这些病例中,每例眶底骨折均伴有严重的全面部或神经创伤。我们未遇到对植入材料本身的任何不良炎症反应。该研究得出结论,使用可吸收板修复眶底骨折是安全的,操作相对容易,并且在大多数情况下有效且无并发症。在存在严重眶部创伤的情况下,可能更适合使用更坚固的植入材料。

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