Pinto Leonardo A P F, Lima Bernardo C, Pinheiro Giulianna L, Rodrigues Gustavo G N
Oral and Maxillofacial Surgery Service, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Centro de Tratamento da Face, Rio de Janeiro, RJ, Brazil.
Natl J Maxillofac Surg. 2023 May-Aug;14(2):326-329. doi: 10.4103/njms.njms_85_22. Epub 2023 Jul 13.
Late reconstructions of gunshot wounds (GSWs) in the orbital area are a true challenge to the oral and maxillofacial surgeon. Usually, the wall defects are large in size and commonly present loss of orbital volume, which can cause ocular dystopia. The only exceptions are when there is an explosion of the orbital walls-that is, blow-out fractures. We encountered a patient with a two-year sequelae after GSW in the face that caused the destructed orbit to have a 2.5 bigger size than the contralateral orbit, requiring meticulous planning of a patient-specific implant (PSI) to correctly reconstruct the orbit volume and bone projection. The PSI was developed using titanium and it had three pieces that could reconstruct all four walls of the orbit. After surgery, the patient regained orbital volume and malar projection, allowing him to benefit from facial symmetry. The PSI can be used to reconstruct all the orbital walls in cases of complex bone defects.
眼眶区域枪伤的晚期重建对口腔颌面外科医生来说是一项真正的挑战。通常，眼眶壁缺损面积较大，常伴有眼眶容积丧失，可导致眼球移位。唯一的例外是眼眶壁发生爆炸，即爆裂性骨折。我们遇到一名患者，面部枪伤后两年出现后遗症，导致受损眼眶比健侧眼眶大2.5倍，需要精心设计定制种植体（PSI）以正确重建眼眶容积和骨投影。PSI采用钛制成，由三块组成，可重建眼眶的所有四个壁。手术后，患者恢复了眼眶容积和颧骨投影，面部对称性得以改善。在复杂骨缺损的情况下，PSI可用于重建所有眼眶壁。
