Tanaskovic Nenad, Trajkovski Branko, Perić Kačarević Željka, Rider Patrick M, Houshmand Alireza, Xiong Xin, Jung Ole, Barbeck Mike
Clinic of Maxillofacial Surgery, Clinical Centre, 78000 Banja Luka, Herzegovina.
Wound Healing and Oral Diagnostic Research Group, College of Dental Medicine, University of Sharjah, 27272 Sharja, UAE.
Materials (Basel). 2019 Jul 24;12(15):2343. doi: 10.3390/ma12152343.
Titanium mesh is a commonly used material for the reconstruction of orbital floor fractures. However, in some instances, a subsequent inflammatory reaction can occur that causes the adhesion of orbital tissue to the titanium mesh. The adhesion of the orbital soft tissue to the mesh causes diplopia, lid rigidity and extraocular movements restriction. This study was performed to determine if the placement of a collagen membrane over a titanium mesh can prevent the adhesion of orbital soft tissue for an improved clinical outcome. Clinical considerations: A case study was performed investigating 106 patients undergoing a periorbital restoration. Seventy-two patients received a titanium mesh without a barrier membrane, 12 patients received a barrier membrane composed of autologous auricular cartilage to provide a barrier function and 22 patients received a pericardium collagen membrane and titanium mesh.
Titanium has been shown to generate an intense inflammatory reaction in host tissues, which can cause fibrosis to adjacent structures. Fibrosis is an essential factor in the repair of fracture sites, however this can lead to adverse effects in the orbital socket. Fibrosis can cause cicatrization and lower eyelid retraction when induced along the lower orbital rim. An improved outcome can be achieved by using a barrier between the titanium mesh and the soft tissue, such as autogenous auricular cartilage, however, only patients treated with a resorbable collagen membrane to act as a soft tissue barricade during site regeneration, prevented the fibrosis reaction and related problems from occurring.
钛网是眼眶底骨折重建常用的材料。然而，在某些情况下，可能会发生后续炎症反应，导致眼眶组织与钛网粘连。眼眶软组织与钛网的粘连会导致复视、眼睑僵硬和眼球运动受限。本研究旨在确定在钛网上放置胶原膜是否可以防止眼眶软组织粘连，以改善临床结果。临床考量：进行了一项病例研究，调查了106例接受眶周修复的患者。72例患者接受了无屏障膜的钛网，12例患者接受了由自体耳廓软骨组成的屏障膜以提供屏障功能，22例患者接受了心包胶原膜和钛网。
已证明钛会在宿主组织中引发强烈的炎症反应，这可能导致相邻结构发生纤维化。纤维化是骨折部位修复的一个重要因素，然而这可能会在眼眶窝产生不良影响。当沿着眶下缘诱导纤维化时，可导致瘢痕形成和下睑退缩。使用钛网和软组织之间的屏障，如自体耳廓软骨，可以取得更好的效果，然而，只有接受可吸收胶原膜治疗的患者，在部位再生过程中作为软组织屏障，才能防止纤维化反应和相关问题的发生。
