结合扩张术的重度眶距增宽症矫正术

Modified technique for correction of the orbital hypertolerism

目的在传统颅内外径路眶距增宽矫正手术的基础上，通过术前眶周软组织扩张并改进术中眶间结构的处理，进一步提高术后效果。方法对2例重度眶距增宽症患者术前3周进行眶周软组织扩张术，双侧颞部各置入100ml软组织扩张器，于术前获得充足的眶外侧软组织量，然后进行传统颅内外径路眶周截骨两侧眶内移矫正术，术后进行内眶距大体测量和三维CT检查随访。结果2例患者内眶距分别由术前的4．4cm和3．2cm矫正到术后的2．0cm和1，4cm；内眦间距分别由术前的6．7cm和4，8cm矫正到术后的5，0cm和3．8cm。结论术前眶周软组织扩张和眶间结构的精确重建可以使眶距增宽症术后效果得到明显提高。

Objective To explore the posibility of para-orbital soft-tissue expansion, before orbital osteotomy and medial translocation procedures with a combined intracranial-extracranial approach. Methods Tissue expansion in the region of the zygomatic and temporal has been undergone for 3 weeks before the traditional intracranial-extracranial approach for orbital osteotomy and medial translocation in two patients. The healing between the orbital bone was studied with measurement of interorbital distance and three-dimensional CT. Results The inter-orbital distance of the two patients decreased from 4.4 cm and 3.2 cm to 2.0 cm and 1.4 cm. The intercanthal distance decreased from 6.7 cm and 4.8 cm to 5.0 cm and 3.8 cm. Conclusions The para-orbital soft-tissue expansion technique may be an effective technique for the stability of the corrected interorbital distance in orbital hypertelorism.