Freihofer H P
Dept. of Oral and Maxillofacial Surgery, University Hospital, Nijmegen, The Netherlands.
J Craniomaxillofac Surg. 1995 Jun;23(3):143-50. doi: 10.1016/s1010-5182(05)80002-2.
In a 12-year period, 56 consecutive patients have undergone secondary periorbital reconstruction after trauma. To evaluate the overall results and the need for further correction, three diagnostic groups were formed. These were: malar bone (n = 16), midface (n = 16) and fronto-orbital fractures (n = 24). Also, in order to judge the reliability of the procedures used most frequently, all osteotomies of the zygoma (n = 32 in 30 patients), canthopexies (n = 26 in 19 patients) and corrections of the bony nasal skeleton (n = 26) were assessed as separate groups. After malar fractures, poor results were found in two cases while after midface fractures the results were quite satisfactory with only one poor result. The outcome after fronto-orbital fractures was also generally satisfactory. However, after a considerable number of later corrections there were still four poor results. Unfortunately, osteotomy of the zygoma left a rather high percentage of unsatisfactory results (19%), but canthopexies scored high and further corrections after secondary surgery of the nasal skeleton eliminated all but one poor result. It is concluded that 7% of our trauma patients undergo secondary and further periorbital corrections. The techniques have become routine. The final outcome was assessed as good in 60% and poor in 20% of patients.
在12年期间，56例连续患者在创伤后接受了二期眶周重建。为了评估总体结果以及进一步矫正的必要性，形成了三个诊断组。分别是：颧骨骨折（n = 16）、面中部骨折（n = 16）和额眶骨折（n = 24）。此外，为了判断最常用手术方法的可靠性，对所有颧骨截骨术（30例患者中的32例）、内眦固定术（19例患者中的26例）和鼻骨骨架矫正术（26例）进行单独分组评估。颧骨骨折后，2例结果较差；面中部骨折后，结果相当满意，仅1例较差。额眶骨折后的结果总体也令人满意。然而，经过相当数量的后期矫正后，仍有4例结果较差。不幸的是，颧骨截骨术的不满意结果比例相当高（19%），但内眦固定术评分较高，鼻骨骨架二期手术后的进一步矫正除1例较差结果外消除了所有不良结果。得出的结论是，我们7%的创伤患者接受了二期及进一步的眶周矫正。这些技术已成为常规操作。最终结果评估为60%的患者良好，20%的患者较差。
