Kim Jiye, Lew Dae Hyun, Roh Tai Suk, Lee Won Jai
*Department of Plastic and Reconstructive Surgery, Yonsei University, Wonju College of Medicine, Wonju †Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Severance Hospital ‡Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Gangnam Severance Hospital, Seoul, Korea.
J Craniofac Surg. 2017 Oct;28(7):e644-e649. doi: 10.1097/SCS.0000000000003782.
The selection of materials for orbital wall reconstruction has been a matter of debate. This study aimed to evaluate the effectiveness of an acellular allogenic dermal matrix (ADM) as an orbital wall reconstruction material and to compare the results of orbital wall reconstruction with the ADM to those of reconstruction with the more widely used absorbable mesh plate and porous polyethylene. We retrospectively reviewed the clinical charts and computed tomography images of 73 patients who underwent orbital reconstruction at 1 institution between March 2013 and February 2014. In the ADM group, the mean defect size of 29 patients was 2.89 cm. After orbital wall reconstruction with ADM, patients with preoperative enophthalmos (7 patients), limited range of eyeball movement (6 patients), and diplopia (12 patients) showed improvements. In the comparative study, the 3 groups showed no significant differences with respect to age distribution (P = 0.522), defect size (P = 0.455), and preoperative findings such as enophthalmos (P = 0.811), diplopia (P = 0.357), and limited range of eyeball movement (P = 0.795). All the preoperative symptoms improved in every group, and in the ADM group, no complication was observed during the postoperative follow-up. ADM is a biocompatible material that combines the flexibility and rigidity required to support the orbital soft tissue. Therefore, it could be an excellent alternative material for orbital wall reconstruction.
眼眶壁重建材料的选择一直存在争议。本研究旨在评估脱细胞异体真皮基质（ADM）作为眼眶壁重建材料的有效性，并将ADM眼眶壁重建的结果与更广泛使用的可吸收网片和多孔聚乙烯重建的结果进行比较。我们回顾性分析了2013年3月至2014年2月期间在1家机构接受眼眶重建的73例患者的临床病历和计算机断层扫描图像。在ADM组中，29例患者的平均缺损大小为2.89厘米。用ADM进行眼眶壁重建后，术前有眼球内陷（7例）、眼球活动范围受限（6例）和复视（12例）的患者症状有所改善。在比较研究中，三组在年龄分布（P = 0.522）、缺损大小（P = 0.455）以及术前表现如眼球内陷（P = 0.811）、复视（P = 0.357）和眼球活动范围受限（P = 0.795）方面均无显著差异。每组所有术前症状均有改善，且ADM组在术后随访期间未观察到并发症。ADM是一种生物相容性材料，兼具支撑眼眶软组织所需的柔韧性和刚性。因此，它可能是眼眶壁重建的一种极佳替代材料。
