Choi Woo Young, Kim Jun Mo, Cheon Ji Seon, Yang Jeong Yeol
Department of Plastic Reconstructive Surgery, Chosun University College of Medicine, Gwangju, Korea.
Arch Craniofac Surg. 2024 Oct;25(5):252-256. doi: 10.7181/acfs.2024.00066. Epub 2024 Aug 23.
This paper presents a novel approach to the correction of zygomatic malposition and secondary reconstruction orbital floor fractures, highlighting the use of hydrated acellular dermal matrix (ADM), specifically CGDerm One-Step, in a case where traditional solid implants failed to maintain structural integrity and volume. A 27-year-old woman with persistent facial deformities following a traumatic incident underwent a transformative procedure that utilized ADM for volume correction and structural support, addressing significant challenges such as enophthalmos and facial contour depression. This approach was necessitated by the descent of the entire orbital floor and a previously placed implant (Medpor), leading to unsatisfactory volume correction. By integrating ADM with titanium-reinforced fan plates (Synpor), the surgery successfully restored the patient's facial symmetry and addressed her functional concerns, including diplopia and limited eye movement. Postoperative evaluations demonstrated the long-term effectiveness of this method, with significant improvements in facial contour and eye symmetry. Our findings suggest that ADM, particularly in its hydrated form, offers a reliable alternative to traditional bone grafts and implants for correcting complex craniofacial deformities, providing both aesthetic and functional benefits. This case underscores the importance of adaptable, tissue-mimicking materials in facial reconstructive surgery, offering insights into their potential for broader application in post-traumatic facial corrections.
本文介绍了一种矫正颧骨错位和二期重建眶底骨折的新方法,重点介绍了在传统固体植入物无法维持结构完整性和体积的情况下,使用水合脱细胞真皮基质(ADM),特别是CGDerm一步法。一名27岁女性在创伤事件后持续存在面部畸形,接受了一项变革性手术,该手术利用ADM进行体积矫正和结构支撑,解决了眼球内陷和面部轮廓凹陷等重大挑战。由于整个眶底下降和先前植入的植入物(Medpor),导致体积矫正效果不理想,因此需要采用这种方法。通过将ADM与钛增强扇形板(Synpor)相结合,手术成功恢复了患者的面部对称性,并解决了她的功能问题,包括复视和眼球运动受限。术后评估证明了该方法的长期有效性,面部轮廓和眼部对称性有显著改善。我们的研究结果表明,ADM,特别是其水合形式,为矫正复杂的颅面畸形提供了一种可靠的替代传统骨移植和植入物的方法,具有美学和功能双重益处。该病例强调了适应性、组织模拟材料在面部重建手术中的重要性,为其在创伤后面部矫正中的更广泛应用潜力提供了见解。