Jung Bok Ki, Yun In Sik, Lee Won Jai, Lew Dae Hyun, Choi Eun Chang, Lee Dong Won
Institute for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine, South Korea.
Department of Otolaryngology, Yonsei University College of Medicine, South Korea.
J Craniomaxillofac Surg. 2016 May;44(5):648-53. doi: 10.1016/j.jcms.2016.01.020. Epub 2016 Feb 1.
Reconstruction after total maxillectomy with extensive orbital floor defects poses a significant challenge for the reconstruction. The aim of this study is to present the outcomes of orbital floor reconstruction using tensor fascia lata slings after total maxillectomy and to compare these results to orbital floor reconstruction using alloplastic implants.
This was a retrospective analysis of 19 consecutive patients who underwent tumor resection with orbital floor removal for malignancies. Reconstructions were performed using either tensor fascia lata slings (Group A) or alloplastic implants (Group B). The early and late postoperative outcomes such as wound infection, plate exposure, ectropion, diplopia, and enophthalmos, were analyzed and compared between the two groups.
Patients in group A had significantly less wound complication than in group B (p < 0.05). In group A, there were no early or late wound complications after the operation. However, in group B, five patients had infection, the plate was exposed in eight of fourteen patients, and three patients had enophthalmos. Eight patients in group B underwent reoperation to correct their complications.
Reconstruction of the orbital floor with a tensor fascia lata sling offers reliable support to the globe and prevents the ophthalmic complications associated with loss of orbital support.
全上颌骨切除术后伴有广泛眶底缺损的重建对重建手术构成了重大挑战。本研究的目的是介绍全上颌骨切除术后使用阔筋膜张肌吊带进行眶底重建的结果，并将这些结果与使用异体植入物进行眶底重建的结果进行比较。
这是一项对19例因恶性肿瘤行肿瘤切除并伴有眶底切除的连续患者的回顾性分析。重建手术采用阔筋膜张肌吊带（A组）或异体植入物（B组）。分析并比较两组术后早期和晚期的结果，如伤口感染、钢板外露、睑外翻、复视和眼球内陷。
A组患者的伤口并发症明显少于B组（p < 0.05）。A组术后无早期或晚期伤口并发症。然而，B组有5例患者发生感染，14例患者中有8例钢板外露，3例患者出现眼球内陷。B组有8例患者接受了再次手术以纠正并发症。
用阔筋膜张肌吊带重建眶底可为眼球提供可靠的支撑，并预防与眶支撑丧失相关的眼科并发症。
