Takeda Teppei, Hardison Scott, Omura Kazuhiro, Ishii Yudo, Mori Ryosuke, Kimple Adam J, Senior Brent A, Otori Nobuyoshi, Klatt-Cromwell Christine, Thorp Brian D
Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.
Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States.
J Neurol Surg B Skull Base. 2024 Oct 5;86(5):556-561. doi: 10.1055/a-2413-3051. eCollection 2025 Oct.
Advances in endoscopic orbital surgery have sparked discussion regarding reconstructive procedures for medial orbital wall defects following tumor removal. This study describes an innovative orbital periosteal suturing technique that addresses the functional and aesthetic concerns created by orbital surgery.
Comprehensive clinical evaluation of a novel orbital periosteal suturing technique for endoscopic medial orbital wall reconstruction.
A retrospective chart review identified five patients who underwent endoscopic transnasal resection and subsequent orbital periosteal suturing for reconstruction. The surgical approach involved a binostril transseptal technique to create a broad surgical corridor. The postoperative follow-up was 13.4 ± 1.8 months.
In the five patients, the mean age was 47.6 ± 13.0 years and the lesions were predominantly distributed on the left side (60%). Reconstruction time with the orbital periosteal suture procedure averaged 47.2 ± 6.6 minutes, employing four to five stitches. No patients experienced short-term complications such as visual acuity defect, new or exacerbated diplopia, or cranial nerve palsy within 2 weeks, and no long-term complications such as enophthalmos or prolonged diplopia were observed.
Orbital periosteal suturing is an effective and resource-efficient technique for endoscopic reconstruction of the medial orbital wall. Surgeons may consider this method among the available options for orbital reconstruction, representing a novel advancement in the field.
内镜眼眶手术的进展引发了关于肿瘤切除后眶内侧壁缺损重建手术的讨论。本研究描述了一种创新的眶骨膜缝合技术，该技术可解决眼眶手术所产生的功能和美学问题。
对一种用于内镜眶内侧壁重建的新型眶骨膜缝合技术进行全面的临床评估。
通过回顾性病历审查，确定了5例接受内镜经鼻切除及随后眶骨膜缝合重建的患者。手术方法采用双侧鼻孔经鼻中隔技术以创建宽敞的手术通道。术后随访时间为13.4 ± 1.8个月。
5例患者的平均年龄为47.6 ± 13.0岁，病变主要分布在左侧（60%）。眶骨膜缝合重建手术的平均时间为47.2 ± 6.6分钟，使用4至5针缝线。2周内无患者出现诸如视力缺陷、新发或加重的复视或颅神经麻痹等短期并发症，也未观察到诸如眼球内陷或持续性复视等长期并发症。
眶骨膜缝合是内镜重建眶内侧壁的一种有效且资源高效的技术。在眼眶重建的可用选择中，外科医生可考虑该方法，这代表了该领域的一项新进展。
