Dunaway D J, David D J
Australian Craniofacial Unit, Women's and Children's Hospital, North Adelaide, South Australia.
Br J Plast Surg. 1996 Dec;49(8):529-35. doi: 10.1016/s0007-1226(96)90129-0.
Seven cases of intraorbital tissue expansion for the treatment of congenital anophthalmos or microphthalmos are presented. The ages of the patients at insertion of the expander ranged from 4 months to 8 years. A 4 ml spherical tissue expander with a remote injection port was inserted into the affected orbit via a bicoronal approach. Expansion periods ranged between 4 months and 3 years and are continuing in 2 patients. Results were assessed by clinical examination, comparison of photographs, 3D CT scans and orbital measurements taken from axial CT scans which were compared with established normal values. Results confirmed enlargement of the orbit with expansion. Long-term expansion over several years established near normal bony growth patterns. Placement of the expander within the orbital soft tissue cone resulted in more symmetrical expansion than subperiosteal placement. An osteotomy releasing the lateral orbital wall in older children allows expansion of the orbit and may reduce the incidence of expander extrusion. Although intraorbital tissue expansion successfully induces orbital growth, improvement in the form and size of the congenitally deficient eyelids is less marked.
本文介绍了7例采用眶内组织扩张术治疗先天性无眼球或小眼球的病例。植入扩张器时患者的年龄在4个月至8岁之间。通过双冠状入路将一个带有远端注射端口的4毫升球形组织扩张器插入患侧眼眶。扩张期为4个月至3年，2例患者仍在继续扩张。通过临床检查、照片对比、三维CT扫描以及从轴向CT扫描获取并与既定正常值进行比较的眼眶测量来评估结果。结果证实随着扩张眼眶增大。数年的长期扩张形成了接近正常的骨生长模式。将扩张器放置在眼眶软组织锥内比骨膜下放置导致更对称的扩张。在大龄儿童中进行外侧眶壁截骨术可使眼眶扩张，并可能降低扩张器挤出的发生率。尽管眶内组织扩张术成功诱导了眼眶生长，但先天性缺损眼睑的形态和大小改善不太明显。
