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首页> 外文期刊>Journal of Oral and Maxillofacial Surgery >Orbitozygomatic fractures with enophthalmos: analysis of 64 cases treated late.
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Orbitozygomatic fractures with enophthalmos: analysis of 64 cases treated late.

机译：眼睑眶y骨骨折：延迟治疗64例分析。

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摘要

To present our treatment experience in delayed orbitozygomatic fracture with enophthalmos and compare the results of traditional surgery, navigation-guided surgery, and 3-dimensional (3D) model-guided surgery in the Departments of Oral and Maxillofacial Surgery and Ophthalmology, Shanghai Ninth People's Hospital, Shanghai, China.This is a retrospective review of a consecutive clinical case series. From 2008 to 2010, 64 patients diagnosed with delayed orbitozygomatic fractures with enophthalmos were treated in the departments. Computed tomography (CT) scan and ophthalmologic examination were performed before surgery. Traditional surgery and computer-assisted treatment (navigation and 3D model) were used for zygoma reduction. Three materials were applied for orbital reconstruction: hydroxyapatite (HA), porous polyethylene (Medpor; Porex Surgical Inc, Newnan, GA), and titanium mesh. Zygomatic reduction and globe projection of different treatment methods were evaluated by postoperative CT scan and clinical follow-up visits.Thirty-nine cases with enophthalmos (mean, 4.96 mm) had traditional surgery for fracture reduction and orbital reconstruction, whereas the other twenty-five cases with enophthalmos (mean, 5.71 mm) had computer-assisted surgery consisting of 3D models to pre-bend the titanium mesh for orbital reconstruction and plates for fracture fixation (n = 25) and navigation-guided surgery (n = 11). Postoperative CT with 3D reconstruction showed good zygomatic reduction in 74.3% of the cases with traditional surgery, 85.7% with computer-assisted 3D models only, and 100% with navigation-guided surgery. In the traditional surgery group, 74.2% of the cases had good postoperative globe projection (≤2 mm), 19.4% had mild enophthalmos (≤3 mm), and 6.5% had moderate enophthalmos (≤4 mm). In the group undergoing computer-assisted 3D model surgery, 75% of the cases had good globe projection and 25% had mild enophthalmos. In the navigation-guided surgery group, 90.9% of the cases had good globe projection and 9.1% had mild enophthalmos. Titanium mesh was used for orbital reconstruction in 47 cases (among which, 12 combined with Medpor or HA), whereas 12 had Medpor only and 5 had HA only. Good globe projection was acquired in 74% of the cases with titanium mesh only, 83% with combined materials, 67% with Medpor only, and 20% with HA only.Computer-assisted surgery can improve the treatment results of delayed orbitozygomatic fracture with enophthalmos. Navigation-guided surgery with a 3D model and titanium mesh with Medpor are the best ways to treat delayed orbitozygomatic fractures with severe enophthalmos.
机译：为了介绍我们在眼眶延迟性眼睑骨折伴有眼睑内翻的治疗经验，并比较上海第九人民医院口腔颌面外科和眼科传统手术，导航手术和3D（3D）模型导向手术的结果中国上海。这是对连续临床病例系列的回顾性回顾。从2008年到2010年，该科共诊治了64例眼睑延缓性眼睑骨折合并内陷的患者。术前进行了计算机断层扫描（CT）扫描和眼科检查。传统手术和计算机辅助治疗（导航和3D模型）用于减少reduction骨瘤。三种材料用于眼眶重建：羟基磷灰石（HA），多孔聚乙烯（Medpor;乔治亚州纽南的Porex外科公司）和钛网。通过术后CT扫描和临床随访评估了不同治疗方法的骨复位和全球投影.39例眼睑狭窄（平均4.96毫米）的患者进行了传统的骨折复位和眼眶重建手术，而其他25例眼睑狭窄（平均5.71毫米）的患者进行了计算机辅助手术，该手术由3D模型组成，用于预弯曲钛网以进行眼眶重建，以及用于固定骨折的钢板（n = 25）和导航引导手术（n = 11）。术后3D重建CT在传统手术中，reduction骨切除率降低了74.3％，仅在计算机辅助3D模型中降低了85.7％，在导航引导手术中降低了100％。在传统手术组中，74.2％的患者术后球体突出良好（≤2 mm），19.4％的患者有轻度眼睑（≤3 mm），6.5％的患者有中度眼睑（≤4 mm）。在接受计算机辅助3D模型手术的组中，有75％的患者具有良好的眼球投影，而25％的患者有轻度的眼睑。在导航引导手术组中，有90.9％的患者具有良好的眼球投影，而9.1％的患者有轻度眼睑突出。钛网用于眼眶重建术47例（其中12例结合Medpor或HA），而12例仅进行Medpor，5例仅进行HA。仅74例钛网，83％联合材料，67％仅Medpor和20％仅HA的患者获得了良好的眼球投影。计算机辅助手术可改善眼眶延迟性眼眶fracture骨骨折的治疗效果。使用3D模型的导航导航手术以及使用Medpor的钛网是治疗重度眼睑延迟性眶delayed骨骨折的最佳方法。

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