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使用计算机辅助导航的钛网眼眶重建术后新鲜与延迟单侧眼眶骨折术后眼球内陷的比较

Comparison of Postoperative Enophthalmos Between Fresh and Delayed Unilateral Orbital Fractures After Orbital Reconstruction With Titanium Mesh Using Computer-Assisted Navigation.

作者信息

Xia Long, Gao Chunli, Gong Xi, Zhang Yi, He Yang, An Jingang

机构信息

Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.

出版信息

J Craniofac Surg. 2023;34(2):663-668. doi: 10.1097/SCS.0000000000009029. Epub 2022 Sep 27.

Abstract

This study compares postoperative enophthalmos between fresh and delayed unilateral orbital fractures after orbital reconstruction with titanium mesh using computer-assisted navigation. The sample was composed of 45 patients with post-traumatic unilateral enophthalmos who were divided into the fresh fracture group and the delayed fracture group. They underwent orbital reconstruction with standard preformed orbital implants and computer-assisted navigation system. The following parameters were measured with computed tomography images: the degree of enophthalmos, orbital volume, and fracture defect area. Patients were reviewed preoperatively (T0), 1 week postoperatively (T1), and 6 months postoperatively (T2). Computed tomography measurements showed that in both groups, the degree of enophthalmos decreased after surgery but increased significantly from T1 to T2 ( P <0.05). ΔE (difference in the degree of enophthalmos between T1 and T2) was similar in patients with fresh and delayed fractures. There was a significant difference in the degree of ΔE between patients with single-wall orbital fractures and those with two-wall orbital fractures. The findings indicate that postoperative enophthalmos is common in both the groups and is closely related to the degree of preoperative enophthalmos. Furthermore, the recurrence of enophthalmos is similar between the 2 groups, but it is higher in patients with orbital fractures involving 2 walls.

摘要

本研究采用计算机辅助导航技术,比较钛网眼眶重建术后新鲜单侧眼眶骨折和陈旧性单侧眼眶骨折的术后眼球内陷情况。样本包括45例创伤后单侧眼球内陷患者,分为新鲜骨折组和陈旧性骨折组。他们接受了标准预制眼眶植入物和计算机辅助导航系统的眼眶重建。利用计算机断层扫描图像测量以下参数:眼球内陷程度、眼眶容积和骨折缺损面积。在术前(T0)、术后1周(T1)和术后6个月(T2)对患者进行复查。计算机断层扫描测量结果显示,两组术后眼球内陷程度均降低,但从T1到T2显著增加(P<0.05)。新鲜骨折和陈旧性骨折患者的ΔE(T1和T2之间眼球内陷程度的差异)相似。单壁眼眶骨折患者和双壁眼眶骨折患者的ΔE程度存在显著差异。研究结果表明,两组术后眼球内陷均很常见,且与术前眼球内陷程度密切相关。此外,两组眼球内陷的复发情况相似,但眼眶骨折累及两壁的患者复发率更高。

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