眶壁骨折整复术后继发眶内上皮植入性囊肿  

Epithelial inclusion cysts associated with alloplastic implants after orbital fracture repair

作　　者：侯志嘉 李冬梅 顼晓琳 周军 HOU Zhi-jia;LI Dong-mei;XU Xiao- lin;ZHOU Jun(Beijing Tongren Eye Centre,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Science,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室

出　　处：《眼科》2019年第4期307-311,共5页Ophthalmology in China

基　　金：首都卫生发展科研专项(2018-2-2053)

摘　　要：目的分析眶壁骨折整复术后眶内上皮植入性囊肿的特征及治疗方法。设计回顾性病例系列。研究对象2005-2017年北京同仁医院继发于眶壁骨折整复手术的眶内上皮植入性囊肿7例。方法收集并分析患者基本资料、骨折部位、植入材料种类、骨折手术距发病时间、临床表现、治疗、术中所见、术后病理及随访情况。主要指标临床特征及治疗效果。结果7例患者中男性6例,平均年龄(35.0±3.8)岁。眶壁骨折修复5例采用羟基磷灰石复合材料,1例采用硅胶材料,1例采用钛网。眶壁骨折整复至囊肿发生时间间隔20个月~11年。5例均表现眼球突出、眼球运动受限、复视、眼球上移位及视力下降。5例均行眶内囊肿摘除术。4例完全取出修复材料。术后病理示所有囊肿均为呼吸道上皮来源。所有患者术后症状均有改善,未见复发。结论眶壁骨折整复术后继发上皮植入性囊肿是一种少见的晚期并发症,可导致眼球突出、移位、运动障碍及复视、视力下降等多种表现,完整手术摘除及取出修复材料可达到较好的治疗效果。Objective To study the clinical features and the effectiveness of the treatment of the epithelial inclusion cysts associated with alloplastic implants after orbital fracture repair.Design Retrospective case series.Participants The study collected 7 patients with epithelial inclusion cysts after orbital fracture treated in Beijing Tongren Hospital between 2005 and 2017.Methods The data including demographic characteristics,site of fracture,implant used,interval between implantation of material and presentation of the orbital cyst,clinical presentation,treatment,histological examination of the cyst and follow up findings were collected and analyzed.Main Outcome Measures The clinical features and treatment results.Results 6 cases were males in all 7 patients,with a mean age of 35.0±3.8 years.There were 5 cases associated with hydroxyapatite compound materials,one case associated with silastic material,and another one associated with titanium meshwork.Orbital cysts developed between 20 months and 11 years after implantation.The clinical presentations in all cases included proptosis,restricted ocular mobility,diplopia,hyperglobus,and reduced visual acuity.The cysts were excised in all cases.The implants were completely removed in 4 cases.Histological analysis confirmed that the cysts were all lined with respiratory cells.After operation,the symptoms were relieved in all cases,no recurrence was noted.Conclusions Epithelial inclusion cyst is a rare and late complication after orbital fracture repair,which may present with various symptoms.Complete excision of the cyst wall with removal of the implants might be the best treatment to relief symptom and prevent recurrence.

关 键 词：眶壁骨折 上皮植人性囊肿 并发症 

分 类 号：R779.6[医药卫生—眼科]