钛网加自体筋膜组织移植修复眼眶底部创伤性缺损

Reconstruction of traumatic orbital floor defect using titanium mesh combined with deep temporal fascia

目的探讨治疗眼眶爆裂骨折眶底缺损的一种新方法。方法 6例眶底缺损患者,采用下睑缘下入路,显露眶下缘及眶底,将疝出至上颌窦内眶内容物复位;在同侧颞区发际内作弧形切口,于颞浅筋膜下层分离,显露颞深筋膜,切取约3 cm×5 cm深筋膜条;依据缺损选择适当大小三维钛网1块(0.6mm厚),按缺损区形状塑形后,将筋膜片覆盖于钛网上,缝合固定;将钛网筋膜补片植入眶底,用2枚钛钉(1.5mm×5mm)固定。结果手术顺利,术后伤口Ⅰ期愈合,眼球形态及运动功能恢复正常。结论钛网加自体筋膜组织移植操作简单易行,术后并发症少,是一种较为理想的修复眶底缺损方法。

Objective To explore a new method for the reconstruction of the orbital bursting fracture and orbital floor defect.Methods Totally 6 cases received the operation.During the operation,the subciliary approach was made to expose the orbital floor defect,then the entrapped or prolapsed orbital tissues were repositioned under direct vision.Through a hairline incision,a 3cm×5 cm deep temporal fascial strip was cut.A titanium mesh was shaped to fit the defect and embedded with the deep temporal fascial strip.Then the complex was implanted into the orbit and repaired the orbital floor defect.Results All the operations had been done successfully with no complications.The follow-up time was 6 months.The globe appearance and motor function were satisfied.Conclusion This study has demonstrated that titanium mesh combined with deep temporal fascia is an ideal method for the reconstruction of orbital floor defect.