MEDPOR—TITAN种植体在爆裂性眶内及下壁骨折修复术的应用分析  

Application analysis of MEDPOR-TITAN implants in combined surgical reconstruction of blowout medial and inferior orbital walls

作　　者：拱伟[1] 董雅儒[1] 崔极哲[1] 

机构地区：[1]吉林大学第二医院眼科,吉林长春130041

出　　处：《中国实用眼科杂志》2015年第5期557-560,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的研究MEDPOR—TITAN种植体在爆裂性眶内及下壁骨折整复术中的应用疗效。方法对吉林大学第二医院眼眶病与眼整形科，自2013年10月至2014年4月就诊的85例（85只眼）爆裂性眶内及下壁骨折患者植入MEDPOR—TITAN种植体。采用下睑缘睫毛下切口联合泪阜结膜入路，充分暴露骨折的各个边缘，将嵌顿疝出的眶内组织（眼外肌及眶脂）充分还纳至眶内，然后将MED—POR—TITAN种植体依骨折面积及眶腔解剖形状修剪，填充于骨折缺损处，缝合骨膜及手术切口。结果术后随访6个月，眼眶CT：骨折对位修复良好，MEDPOR—TITAN种植体固定良好、无移位、无排斥反应。术眼眼球内陷及眼球运动较术前明显改善，无视力下降、感染及其他不良反应。结论爆裂性眶内及下壁骨折患者早期（伤后2～3周）施行MEDPOR—TITAN种植体修复，可以有效地矫正患者的眼球内陷，改善复视，且术后炎症反应轻，组织相容性好，在眼眶爆裂性眶内及下壁骨折整复术中是一种安全有效、值得推广的填充材料。Objective To explore the application effect of MEDPOR-TITAN implants in com- bined surgical reconstruction of blowout medial and inferior orbital walls. Methods From October 2013 to April 2014, 85 patients （85 eyes） with blowout medial and inferior orbital walls adopted com- bined surgical reconstruction using MEDPOR-TITAN implants. The surgical repair was undergone via the joint lower limbos palpebralis and the transconjunctival incision. Fully exposed fractures each edge to obtain an adequate view of the fracture area, and the incarcerated hernia of soft tissues （extraocular muscle and orbital fat body） surrounding the orbit were subsequently restored and recovered. Then MED- POR-TITAN implant was trimmed according to the fracture area and the anatomical shape of the orbital cavity and was inserted and fixed as a pad to fill up the defect of the orbital wall in the surgery of re- construction. Finally, the periosteum and other surgical incision were sutured. Results Following up six months after surgery, the image of orbital CT scans displaed fracture counterpoint good repair. MED- POR-TITAN implants were well fixed, with better results, no hypoglobus and no extrusion reaction. The enophthalmos and eye movement were significantly improved compared with the preoperative. No visual loss, no rejection or other adverse reactions occurred. Conclusions The patients with blowout fractures of orbital medial and inferior walls early （within 2-3 weeks of injury） treated through surgical reconstruc- tion using MEDPOR-TITAN implants. The exophthalmos are well corrected; diplopia and the limit of eyeball movement are improved. The inflammation is mild after surgery, with better tissue compatibility, fewer complications. MEDPOR- TITAN implants is a good substitute material of bone graft and ismuch better than other artificial material.

关 键 词：爆裂性眶内及下壁骨折 MEDPOR—TITAN种植体 

分 类 号：R782.2[医药卫生—口腔医学]