Cox Jacob T, Tian Jing, Merbs Shannath, Mahoney Nicholas R
Division of Oculoplastic Surgery, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Biostatistics Consulting Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Craniomaxillofac Trauma Reconstr. 2019 Sep;12(3):167-173. doi: 10.1055/s-0038-1676636. Epub 2019 Jan 16.
This article aimed to assess the effects of (1) mesh (e.g., uncoated anatomic titanium plates) versus non-mesh (e.g., porous polyethylene-coated titanium sheets) implant materials and (2) drain placement on the accumulation of blood within the maxillary sinus following surgical repair of orbital floor fractures. Ninety-two patients who received orbital floor fracture repair between 2008 and 2014 were selected, with equal case numbers between categories: (1) non-mesh implant, without drain; (2) non-mesh implant, with drain; (3) mesh implant, without drain; and (4) mesh implant, with drain. Lesion-mapping software was used to measure blood and sinus volumes in postoperative computed tomographic images. Average postoperative maxillary sinus filling was 49% ± 29%. Average sinus filling was similar between mesh and non-mesh implant materials; this was true in cases with a drain (45 vs. 40%, respectively) and without (57 vs. 52%, respectively). Orbital drain placement was associated with a significant reduction ( = 0.048) in maxillary sinus filling of 12%. Mesh and non-mesh implant materials allow for similar drainage of orbital blood into the maxillary sinus postoperatively. In the majority of cases, space is available within the maxillary sinus to allow for drainage of orbital blood. Intraoperative drain placement is associated with reduced blood pooling within the maxillary sinus, suggesting it allows for drainage of orbital blood to the outside world.
本文旨在评估(1)网状植入材料（如未涂层解剖型钛板）与非网状植入材料（如多孔聚乙烯涂层钛板）以及(2)引流管放置对上颌窦内眶底骨折手术修复后血液积聚的影响。选取了2008年至2014年间接受眶底骨折修复的92例患者，各分类病例数相等：(1)非网状植入物，无引流管；(2)非网状植入物，有引流管；(3)网状植入物，无引流管；(4)网状植入物，有引流管。使用病变映射软件测量术后计算机断层扫描图像中的血液和窦腔体积。术后上颌窦平均充盈率为49%±29%。网状和非网状植入材料的平均窦腔充盈率相似；有引流管的病例（分别为45%和40%）和无引流管的病例（分别为57%和52%）均如此。眶引流管的放置与上颌窦充盈率显著降低（P = 0.048）12%相关。网状和非网状植入材料术后眶内血液流入上颌窦的引流情况相似。在大多数情况下，上颌窦内有空间可用于眶内血液引流。术中放置引流管与上颌窦内血液积聚减少相关，表明其可使眶内血液引流至体外。
