University of Nantes, CHU Nantes, Service de Chirurgie Maxillo-Faciale et Stomatologie, F-44000, Nantes, France.
University of Nantes, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, F-44000, Nantes, France.
Head Neck. 2023 Jun;45(6):1581-1593. doi: 10.1002/hed.27352. Epub 2023 Mar 23.
This systematic review aimed to evaluate the surgical techniques used for orbital floor reconstruction after Brown class III maxillectomy for cancer. Three databases were searched from January 1990 to January 2022. Of the 614 studies identified, 20 were retained after eligibility assessment. The surgical techniques were classified into four groups: free bone flaps (A), alloplastic implants (B), bone grafts (C), and soft-tissue reconstructions (D). Ectropion and diplopia concerned 42.6% and 6.6% of the patients, respectively. Soft tissue reconstruction was more likely to cause ectropion (17/27), followed by the reconstruction techniques of group B (34/79), group C (26/70), and group A (1/7). Postoperative enophthalmos was identified in 18 patients (9.6%), mostly in group D (5/35), followed by groups B (8/68), A (3/33), and C (2/52). Free bone flaps and alloplastic implants represent good reconstructive options in terms of postoperative ocular parameters.
本系统评价旨在评估用于癌症行 Brown 分类 III 上颌骨切除术的眶底重建的手术技术。从 1990 年 1 月至 2022 年 1 月,三个数据库被搜索。在资格评估后,保留了 614 项研究中的 20 项。手术技术分为四组:游离骨瓣(A)、同种异体植入物(B)、骨移植(C)和软组织重建(D)。外翻和复视分别占患者的 42.6%和 6.6%。软组织重建更容易导致外翻(27 例中有 17 例),其次是 B 组(79 例中有 34 例)、C 组(70 例中有 26 例)和 A 组(7 例中有 1 例)。18 名患者(9.6%)出现术后眼球内陷,主要发生在 D 组(35 例中有 5 例),其次是 B 组(68 例中有 8 例)、A 组(33 例中有 3 例)和 C 组(52 例中有 2 例)。游离骨瓣和同种异体植入物在术后眼部参数方面代表了良好的重建选择。