AlSubaie Majed Fehaid, Al-Sharydah Abdulaziz Mohammad, Nassim Hala M, Alhawsawi Abrar
Department of Ophthalmology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar City, Eastern Province, Saudi Arabia.
Department of Ophthalmology, Dhahran-Eye-Specialist-Hospital, Al Jamiah, Dhahran City, Eastern Province, Saudi Arabia.
Open Access Emerg Med. 2022 May 25;14:223-232. doi: 10.2147/OAEM.S359173. eCollection 2022.
Blowout fracture is defined as an internal orbital fracture that does not involve the orbital rim. This type of fracture results in the loss of tissue and disruption of the structure of the orbital wall. The symptoms and signs include pain, enophthalmos, diplopia, orbital emphysema, and ecchymosis. The surgeon's main goal is to reconstruct the orbit in the best possible manner to achieve optimal anatomy and functionality of the orbit wall postoperatively. There is no consensus regarding the best material for use in surgical orbital reconstruction, despite the commercial availability of several biological and manufactured materials. Moreover, material selection is often based on the practitioner's preferences/experience and patient safety. This study reported two cases of orbital fracture reconstruction using moldable methyl polymethacrylate as a bone surrogate. This material has already been used in dentistry, neurosurgery, and orthopedic surgery and is potentially hazard-free for orbit surgery.
Two victims of motor vehicle collisions presented with blowout orbital fractures. Cross-sectional imaging revealed inferior fractures involving the orbital wall. High-resolution tomographic modeling was used to plan surgical orbital floor reconstruction using moldable polymethyl methacrylate material. The short-term outcome of the implant appeared favorable at the one-year follow-up, based on regular patient monitoring and cross-sectional imaging assessment. Postoperative improvement with positive clinical outcomes was observed during both patients' follow-up visits.
Moldable polymethyl methacrylate can be used safely and effectively for reconstructive surgeries for the management of blowout orbital fractures. This new technique ensured a satisfactory short-term postoperative orbital configuration and tolerance and good esthetic and functional results without adverse effects. This customizable product is affordable and easy to fabricate.
爆裂性骨折被定义为不涉及眶缘的眶内骨折。这种类型的骨折会导致组织丧失和眶壁结构破坏。症状和体征包括疼痛、眼球内陷、复视、眶周气肿和瘀斑。外科医生的主要目标是以尽可能最佳的方式重建眼眶，以实现术后眶壁的最佳解剖结构和功能。尽管有几种生物材料和人工制造材料可供商业使用，但对于用于眼眶手术重建的最佳材料尚无共识。此外，材料的选择通常基于从业者的偏好/经验以及患者的安全性。本研究报告了两例使用可塑形聚甲基丙烯酸甲酯作为骨替代物进行眼眶骨折重建的病例。这种材料已用于牙科、神经外科和整形外科手术，并且对眼眶手术可能无危害。
两名机动车碰撞受害者出现眼眶爆裂性骨折。横断面成像显示眶壁下方骨折。使用高分辨率断层扫描建模来计划使用可塑形聚甲基丙烯酸甲酯材料进行眼眶底重建。根据定期的患者监测和横断面成像评估，在一年的随访中植入物的短期结果似乎良好。在两名患者的随访期间均观察到术后改善且临床结果呈阳性。
可塑形聚甲基丙烯酸甲酯可安全有效地用于眼眶爆裂性骨折治疗的重建手术。这种新技术确保了术后短期内令人满意的眼眶形态和耐受性以及良好的美学和功能效果，且无不良反应。这种可定制的产品价格实惠且易于制造。
