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钛微网修复眶底骨折:我们的经验

Reconstruction of Orbital Floor Fractures with Titanium Micromesh: Our Experience.

作者信息

Chattopadhyay Chandrashekhar, Dev Vikas, Pilania Dinesh, Harsh Aditya

机构信息

Department of General Dentistry, Dr SN Medical College, Jodhpur, 342010 India.

出版信息

J Maxillofac Oral Surg. 2022 Jun;21(2):369-378. doi: 10.1007/s12663-020-01407-x. Epub 2020 Jul 9.

Abstract

AIMS AND OBJECTIVE

The purpose of this study was to assess the use and accuracy of the titanium micromesh for primary internal orbital reconstruction in cases of either pure or impure orbital blowout fractures.

DESIGN

Retrospective case series of 21 patients with a mean follow-up of 12 months.

PLACE

Department of Dental Surgery of a teaching tertiary medical college Hospital.

MATERIAL AND METHODS

Twenty-one consecutive patients who underwent surgical reconstruction of orbital floor/or Combination of floor and rim fractures using titanium micromesh.

OUTCOME AND EVALUATION

Persistence of diplopia, orbital dystopia, implant extrusion, enophthalmos, infection, and complications. The recorded data included age, gender, cause of trauma, diplopia, enophthalmos, ocular motility, preoperative orbital PNS/CT, and postoperative paranasal sinus view skull preoperative and postoperative ophthalmological examination.

RESULTS

Most of the patients were males and resulted from trauma inflicted during RTA, sport injuries or assault. The most Common fracture pattern was impure Blow out fractures, and commonly associated other facial fractures were midfacial fractures. Clinical examination along with diagnostic aids such as computed tomography of orbital fractures was used. Orbital floor exploration was performed in 21 cases due to functional or aesthetic deficits. All orbital floor bone defects required reconstruction. In these cases, orbital floor was reconstructed with .3 mm titanium micromesh implant. We did not encounter any major complications related to the incisions or implant material, though sample size was small. The rate of complication in which correction was difficult (diplopia) was lower [4%, 1 case].

CONCLUSION

Titanium mesh gives excellent result in orbital floor fractures. Surgical anatomical landmarks knowledge is very important to prevent any intra- or postoperative complications.

摘要

目的

本研究旨在评估钛微网在单纯性或非单纯性眼眶爆裂性骨折一期眼眶内重建中的应用及准确性。

设计

对21例患者进行回顾性病例系列研究,平均随访12个月。

地点

一所教学型三级医学院附属医院的口腔外科。

材料与方法

连续21例患者使用钛微网进行眶底手术重建/眶底与眶缘联合骨折重建。

结果与评估

复视、眼眶移位、植入物外露、眼球内陷、感染及并发症的持续情况。记录的数据包括年龄、性别、外伤原因、复视、眼球内陷、眼球运动、术前眼眶鼻窦/CT以及术前术后眼科检查。

结果

大多数患者为男性,外伤原因包括交通事故、运动损伤或袭击。最常见的骨折类型是非单纯性爆裂性骨折,常见的合并其他面部骨折为面中部骨折。采用临床检查及眼眶骨折计算机断层扫描等诊断辅助手段。因功能或美观缺陷对21例患者进行了眶底探查。所有眶底骨缺损均需重建。在这些病例中,用0.3毫米钛微网植入物重建眶底。尽管样本量较小,但我们未遇到与切口或植入材料相关的任何重大并发症。难以矫正的并发症(复视)发生率较低[4%,1例]。

结论

钛网在眶底骨折治疗中效果良好。了解手术解剖标志对于预防术中或术后并发症非常重要。

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Reconstruction of Orbital Floor Fractures with Titanium Micromesh: Our Experience.钛微网修复眶底骨折:我们的经验
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本文引用的文献

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Current Strategies in Post-traumatic Orbital Reconstruction.创伤后眼眶重建的当前策略
J Maxillofac Oral Surg. 2019 Dec;18(4):483-489. doi: 10.1007/s12663-019-01235-8. Epub 2019 Jun 12.
2
Management of orbital fractures: challenges and solutions.眼眶骨折的管理:挑战与解决方案。
Clin Ophthalmol. 2015 Nov 17;9:2127-37. doi: 10.2147/OPTH.S80463. eCollection 2015.
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Surgical approaches to the orbit in primary and secondary reconstruction.眼眶一期及二期重建的手术入路
Facial Plast Surg. 2014 Oct;30(5):537-44. doi: 10.1055/s-0034-1394100. Epub 2014 Nov 14.
8
Epidemiology and management of orbital fractures.眼眶骨折的流行病学与治疗
Curr Opin Ophthalmol. 2004 Oct;15(5):416-21. doi: 10.1097/01.icu.0000136113.56288.87.
9
Reconstruction of the floor of the orbit by bone grafts.采用骨移植重建眶底。
Arch Ophthal. 1950 Jul;44(1):1-21. doi: 10.1001/archopht.1950.00910020004001.

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