Camuzard J F, Raspaldo H, Santini J, Vaille G, Demard F
Service de Chirurgie Cervico et Maxillo-Faciale, Centre Antoine-Lacassagne, Nice.
Rev Stomatol Chir Maxillofac. 1988;89(4):204-9.
Based on a personal series of 160 cases of surgically treated closed orbital floor fractures, the authors discuss the various reconstruction procedures and their respective indications. Emphasis is placed on surgical access and osteoplasty techniques. In this series, both cutaneous upper eyelid (127 patients) and transconjunctival approaches (33 cases) were used. Access through the upper eyelid gave the fewest complications; transconjunctival surgery was reserved for pure "blow-out" fractures. Several materials were tested for osteoplasty: conventional techniques included Silastic sheets (112 cases), corticospongiosal bone grafts (16 cases), and lyophilized dura mater (9 cases); new techniques included use of resorbable thermoplastic sheets (23 cases). Choice of a material depends on the size of the defect to be filled. Thin Silastic sheets are the ideal solution for small defects. Bone grafts are reserved for extensive losses of substance.
基于作者个人一系列160例手术治疗的闭合性眶底骨折病例，作者讨论了各种重建手术及其各自的适应症。重点在于手术入路和骨成形术技术。在该系列中，采用了经上睑皮肤入路（127例患者）和经结膜入路（33例）。经上睑入路的并发症最少；经结膜手术仅用于单纯的“爆裂性”骨折。对几种用于骨成形术的材料进行了测试：传统技术包括硅橡胶片（112例）、皮质松质骨移植（16例）和冻干硬脑膜（9例）；新技术包括使用可吸收热塑性片材（23例）。材料的选择取决于要填充的缺损大小。薄硅橡胶片是小缺损的理想解决方案。骨移植用于大面积骨质缺损。
