Singh Daman D, Schorn Lara, Strong E Bradley, Grant Michael, Schramm Alexander, Hufendiek Karsten, Gellrich Nils-Claudius, Rana Majeed
Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
Department of Otolaryngology, University of California Davis School of Medicine, Sacramento, CA, USA.
Craniomaxillofac Trauma Reconstr. 2021 Mar;14(1):29-35. doi: 10.1177/1943387520935004. Epub 2020 Jul 9.
This study presents a case-control study of 33 patients who underwent secondary orbital reconstruction, evaluating techniques and outcome.
Adequate functional and aesthetical appearance are main goals for secondary orbital reconstruction. Insufficient premorbid orbital reconstruction can result in hypoglobus, enophthalmos, and diplopia. Computer-assisted surgery and the use of patient-specific implants (PSIs) is widely described in the literature. The authors evaluate the use of selective laser-melted PSIs and hypothesize that PSIs are an excellent option for secondary orbital reconstruction.
The sample was composed of 33 patients, previously treated with primary orbital reconstruction, presenting themselves with indications for secondary reconstruction (i.e. enophthalmos, diplopia, or limited eye motility). Computed tomography and/or cone beam data sets were assessed before and after secondary reconstruction comparing intraorbital volumes, infraorbital angles, and clinical symptoms. Clinical outcomes were assessed using a standardized protocol.
Results show a significant change in intraorbital volumes and a reduction of clinical symptoms after secondary reconstruction.
Outcomes of this study suggest that secondary orbital reconstruction can be performed routinely using selective laser-melted PSIs and titanium spacers.
本研究为一项病例对照研究，纳入了33例行二期眼眶重建术的患者，对手术技术及结果进行评估。
获得足够的功能及美观外观是二期眼眶重建的主要目标。术前眼眶重建不足可导致眼球下陷、眼球内陷及复视。计算机辅助手术及使用定制植入物（PSI）在文献中有广泛描述。作者评估了选择性激光熔融PSI的应用，并假设PSI是二期眼眶重建的理想选择。
样本包括33例曾接受一期眼眶重建术的患者，这些患者有二期重建指征（即眼球内陷、复视或眼球活动受限）。在二期重建前后评估计算机断层扫描和/或锥形束数据集，比较眶内容积、眶下角度及临床症状。使用标准化方案评估临床结果。
结果显示二期重建后眶内容积有显著变化，临床症状减轻。
本研究结果表明，二期眼眶重建可常规使用选择性激光熔融PSI和钛制间隔物进行。
