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用于眼眶底壁和内侧壁骨折三维重建的预成型眶内植入物:一项前瞻性临床研究

Matrixmidface Preformed Orbital Implants for Three-Dimensional Reconstruction of Orbital Floor and Medial Wall Fractures: A Prospective Clinical Study.

作者信息

Chodankar Neha Umakant, Dhupar Vikas, Akkara Francis, Vijay Vathsalya

机构信息

Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, India.

Department of Ophthalmology, Goa Medical College and Hospital, Bambolim, India.

出版信息

Craniomaxillofac Trauma Reconstr. 2024 Jun;17(2):104-114. doi: 10.1177/19433875231171749. Epub 2023 Apr 20.

Abstract

STUDY DESIGN

Prospective Interventional study.

OBJECTIVE

To evaluate the efficiency of Matrixmidface preformed Orbital plates for three-dimensional reconstruction of orbital floor and medial wall fractures.

METHODS

This prospective institutional clinical study was conducted on a group of 14 patients who underwent repair of orbital floor and medial wall fracture defects using Matrixmidface Preformed Orbital plates and open reduction and internal fixation of associated fractures. The following parameters were studied preoperative and postoperative enophthalmos, hypoglobus, orbital volume; correction of diplopia, intraoperative and postoperative complications.

RESULTS

All 14 patients were males aged between 19 and 42 years. The most common mode of injury was found to be road traffic accidents (RTAs) followed by self-fall and trauma at workplace. Orbital fractures were associated with other concomitant maxillofacial fractures in 12 patients (85.7%) while 2 patients (14.3%) had pure blowout fractures. Significant improvement of enophthalmos was noted from preoperative period to 1 week, 6 weeks, and 6 months postoperatively ( respectively). Out of 11 patients with preoperative hypoglobus, 5 patients (45.45%) had persistent hypoglobus in the immediate postoperative period which reduced to 4 patients (36.36%) at 6 weeks postoperatively The postoperative orbital volume of fractured side ranged from 20.3 cm to 26.76 cm with a mean of 23.50 cm ± 1.74. The mean difference between the volumes of the repaired and uninjured sides was found to be .27 cm ± .39 () denoting that the reconstruction of the orbit closely approximated that of the uninjured side.

CONCLUSIONS

The Matrixmidface Preformed Orbital plate provides exceptional reconstruction of the orbital blowout fracture defects and ensures satisfactory results clinically and radiographically. The plate ensures an approximate recreation of topographical anatomy of the orbit and adequately restores the orbital volume. It provides adequate correction of asymmetry, hypoglobus, enophthalmos and attempts to restore eye movements, without causing any significant postoperative complication.

摘要

研究设计

前瞻性干预性研究。

目的

评估Matrixmidface预成型眶板用于眶底和眶内侧壁骨折三维重建的效果。

方法

对一组14例患者进行了这项前瞻性机构临床研究,这些患者使用Matrixmidface预成型眶板修复眶底和眶内侧壁骨折缺损,并对相关骨折进行切开复位内固定。研究了以下参数:术前和术后眼球内陷、眼球下移、眶容积;复视的矫正情况、术中及术后并发症。

结果

14例患者均为男性,年龄在19至42岁之间。最常见的受伤方式是道路交通事故(RTA),其次是自摔和工作场所外伤。12例患者(85.7%)的眶骨折与其他颌面部骨折同时存在,而2例患者(14.3%)为单纯爆裂性骨折。从术前到术后1周、6周和6个月,眼球内陷有显著改善(分别)。术前有眼球下移的11例患者中,5例患者(45.45%)术后即刻仍有持续性眼球下移,术后6周减少至4例患者(36.36%)。骨折侧术后眶容积在20.3 cm至26.76 cm之间,平均为23.50 cm±1.74。修复侧与未受伤侧的容积平均差异为0.27 cm±0.39(),表明眶重建与未受伤侧非常接近。

结论

Matrixmidface预成型眶板能出色地重建眶爆裂性骨折缺损,在临床和影像学上确保令人满意的结果。该板能确保近似重现眶的局部解剖结构,并充分恢复眶容积。它能充分矫正不对称、眼球下移、眼球内陷,并试图恢复眼球运动,且不会引起任何明显的术后并发症。

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本文引用的文献

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Prevalence and severity of orbital blowout fractures.眼眶爆裂性骨折的患病率及严重程度。
Br J Oral Maxillofac Surg. 2020 Nov;58(9):e93-e97. doi: 10.1016/j.bjoms.2020.07.001. Epub 2020 Jul 14.
2
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Extra-ocular movement restriction and diplopia following orbital fracture repair.眼眶骨折修复术后的眼球运动受限和复视
Am J Otolaryngol. 2018 Jan-Feb;39(1):34-36. doi: 10.1016/j.amjoto.2017.08.008. Epub 2017 Aug 25.
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Evidence-based medicine: Orbital floor fractures.循证医学:眶底骨折
Plast Reconstr Surg. 2014 Dec;134(6):1345-1355. doi: 10.1097/PRS.0000000000000719.
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Reconstruction of Post-traumatic Internal Orbital Wall Defects with Titanium Mesh.钛网修复创伤性眶内壁缺损
J Maxillofac Oral Surg. 2013 Dec;12(4):418-23. doi: 10.1007/s12663-012-0444-9. Epub 2012 Oct 26.

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