Motomura Hisashi, Deguchi Ayaka, Ataka Shinsuke, Fujii Naho, Hatano Takaharu, Fujikawa Heishiro, Maeda Shusaku, Haraoka Goichi
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Department of Aesthetic Surgery, Kobe University Hospital, Hyogo, Japan.
Plast Reconstr Surg Glob Open. 2021 Jan 26;9(1):e3352. doi: 10.1097/GOX.0000000000003352. eCollection 2021 Jan.
The quality of life of the face involves mainly its configuration, and it plays an important functional role in communication skills. Thus, having artificial eyes is extremely essential in maintaining the quality of life of patients who have lost their eyeballs. We will present the details of the technique, including tips and innovations for eye socket reconstruction using spherical costal cartilage implant, which leads to dynamic and aesthetic results.
There were 19 cases of eye socket reconstruction using costal cartilages from 2008 to 2020. The patient age range was 18-77 years old. There were 10 cases of anophthalmia and 9 cases of ocular phthisis. In our operative method, we created the costal cartilage implant by harvesting the sixth costal cartilage of the affected side. If extraocular muscle remained, we sutured each muscle to the cartilage.
Our method made application of thin artificial eyes possible in all cases. Regarding postoperative complications, there were 1 case of postoperative infection and 1 case of vascular failure of temporoparietal fascial flap. Seventeen cases were wet socket, and 2 cases were dry socket. We had attained movement of the artificial eye in 15 cases.
Eye socket reconstruction is considered one of the most challenging operations, and various postoperative complications appear in the long term. Costal cartilages are considered as the most suitable materials to create the base of artificial eyes.
面部的生活质量主要涉及其形态，并且在沟通技巧中发挥着重要的功能作用。因此，对于眼球缺失的患者而言，佩戴义眼对于维持其生活质量极为重要。我们将介绍使用球形肋软骨植入物进行眼窝重建的技术细节，包括技巧和创新点，该技术可带来动态且美观的效果。
2008年至2020年期间，共19例患者采用肋软骨进行眼窝重建。患者年龄范围为18至77岁。其中无眼球患者10例，眼球痨患者9例。在我们的手术方法中，通过获取患侧第六肋软骨来制作肋软骨植入物。若眼外肌尚存，我们将每条肌肉缝合至软骨上。
我们的方法使得在所有病例中都能够使用薄型义眼。关于术后并发症，术后感染1例，颞顶部筋膜瓣血管衰竭1例。17例为湿性眼窝，2例为干性眼窝。15例患者的义眼实现了活动。
眼窝重建被认为是最具挑战性的手术之一，长期会出现各种术后并发症。肋软骨被认为是制作义眼基座最合适的材料。
