骨整合种植体支持的赝复体矫正严重眶部畸形六例分析  

Osseointegrated implant supported prostheses in the rehabilitation of severe orbital deformity in 6 cases

作　　者：侯志嘉 刘静明[2] 宋铁砾[2] 陈志远[2] 赵士春 李冬梅 Hou Zhijia;Liu Jingming;Song Tieli;Chen Zhiyuan;Zhao Shichun;Li Dongmei(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Ophthalmology & Visual Science Key Lab.,Beijing 100730,China;Department of Stomatology,Beijing Tongren Hospital,Capital Medical University,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北京市眼科学与视觉科学重点实验室,100730 [2]首都医科大学附属北京同仁医院口腔科,100730

出　　处：《中华眼科杂志》2019年第9期665-669,共5页Chinese Journal of Ophthalmology

摘　　要：目的探讨骨整合种植体支持的赝复体对眼眶部严重畸形的矫正效果.方法回顾性病例系列研究.收集2010年至2016年间在首都医科大学附属北京同仁医院北京同仁眼科中心因重度眼眶畸形行眶周骨整合种植体+赝复体矫正治疗的6例(6只眼)患者的临床资料,分析种植体数量及位置、术后外观及并发症、赝复体佩戴情况等.结果 6例患者中男性4例,女性2例,平均年龄27岁(16~44岁).因恶性肿瘤行眶内容摘除或眼球摘除并接受放射治疗4例,因炎性假瘤行眶内容摘除1例,因爆炸伤及继发感染导致眶内容缺失1例.每例患者均植入种植体3枚,共18枚,其中植入外上眶缘9枚,外下眶缘6枚,内上眶缘1枚,内下眶缘2枚.1枚外上眶缘种植体植入半年后脱落,于内下眶缘重新植入1枚.所有患者随访均在2年以上,未再出现种植体失败,周围皮肤无明显炎性反应.所有患者最终均能佩戴假体,面部外观均得到明显改善.结论采用骨整合种植体支持的赝复体可以矫正眼眶组织缺损导致的严重畸形,赝复体固位良好,有助于提高患者的生活质量.Objective To assess the effectiveness of osseointegrated implant supported prostheses in the rehabilitation of severe orbital deformity. Methods Retrospective case series. The study collected 6 patients (6 eyes) with severe orbital deformity, who were treated with osseointegrated implant supported prostheses between 2010 and 2016 in Beijing Tongren Eye Center, Beijing Tongren Hospital. Data included demographic characteristics, causes of the deformity, the history of radiotherapy, the site, number and survival of implants, and the ability to wear prostheses. Results Among the 6 patients, 4 were males, and 2 were females, with a mean age of 27 (16-44) years. The deformity resulted from evisceration or enucleation and radiotherapy for malignancies in 4 patients, from evisceration because of inflammatory pseudotumor in 1 patient, and from enucleation and debridement because of explosion injury and secondary infection in 1 patient. Each patient received 3 implants at the first operation. A total of 18 implants were installed, including 9 placed into the lateral aspect of the supraorbital rim, 6 into the lateral aspect of the infraorbital rim, 1 into the medial aspect of the supraorbital rim, and 2 into the medial aspect of the infraorbital rim. One superior lateral implant failed half a year after implantation, and an additional implant was implanted into the medial aspect of the inferior medial orbital rim for prostheses retention. All the patients were followed up for more than 2 years. No other failures were observed. The soft tissue reaction was acceptable in all patients. All of them were able to wear prostheses with satisfying appearance. Conclusions Osseointegrated implants provid excellent retention for orbital prostheses. This technique could be used in patients with severe orbital deformity to improve their life quality.

关 键 词：眶内容摘除术 骨整合 眼眶植入物 

分 类 号：R779.6[医药卫生—眼科]