Papay F A, Zins J E, Hahn J F
Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, Ohio 44195, USA.
J Craniofac Surg. 1996 Mar;7(2):133-9. doi: 10.1097/00001665-199603000-00011.
Sphenoid wing defects of the posterior orbit and frontal and middle cranial fossae, secondary to tumor ablation, create difficulties in orbital and cranial base reconstruction. Autogenous split calvarial bone grafts harvested at the time of neurosurgical tumor ablation were used to reconstruct sphenoid wing defects in nine patients between July 1983 and January 1993. Meningioma is the most common tumor resected in this series, followed by fibrous dysplasia. Patient follow-up ranged from 1 to 5 years with a mean of 3 years. Calvarial bone grafting was performed to restore continuity of frontal bone, supraorbital ridge, orbital roof, and lateral wall and floor. All patients demonstrating proptosis showed either complete resolution or significant improvement postoperatively by exophthalmometry. Postoperative pulsatile exophthalmos occurred transiently in one patient but resolved spontaneously. Postoperative diplopia occurred in two patients, which subsequently resolved within 6 weeks. There were no incidents of postoperative osteomyelitis or bone graft loss within the reported postoperative period. Conventional and three-dimensional computed axial tomographic scans did not demonstrate bony resorption resulting in structural instability in any of the cases with this reconstructive method.
继发于肿瘤切除的后眶、额颅窝和中颅窝蝶骨翼缺损给眼眶和颅底重建带来困难。1983年7月至1993年1月期间，9例患者在神经外科肿瘤切除时采用取自自体的劈开颅骨骨移植来重建蝶骨翼缺损。该系列中最常切除的肿瘤是脑膜瘤，其次是骨纤维发育不良。患者随访时间为1至5年，平均3年。进行颅骨骨移植以恢复额骨、眶上嵴、眶顶、外侧壁和眶底的连续性。所有表现为眼球突出的患者术后经眼球突出度测量均显示完全消退或显著改善。1例患者术后短暂出现搏动性眼球突出，但自行消退。2例患者术后出现复视，随后在6周内消退。在报告的术后期间内未发生术后骨髓炎或骨移植丢失事件。采用这种重建方法的任何病例，常规和三维计算机轴向断层扫描均未显示骨质吸收导致结构不稳定。
