钛网联合多孔聚乙烯植入治疗内壁合并下壁眼眶骨折

Titanium mesh combined with Medpor implantation in orbital reconstruction for medial and inferior orbital wall fractures

目的探讨应用钛网联合多孔高密度聚乙烯板（Medpor）植入治疗内壁合并下壁眼眶骨折的疗效。方法回顾性分析12例（12眼）内壁合并下壁眼眶骨折行钛网联合Medpor植入的手术效果，术前眼球内陷I〉3mm者10例，内陷2—3mm者2例，复视5例，眼球明显下移2例，术中均经下睑缘下皮肤切口，下壁骨折区行钛网植入，内壁骨折区及眼球内陷重的行Medpor植入矫正。结果术后随访3—6个月，眼球内陷均矫正至2mm以内，复视完全消失4例，明显改善1例，2例眼球下移均消失，视力无明显变化。术后无感染、植入物脱出或排斥、移位等并发症。结论应用钛网联合Medpor植入治疗内壁合并下壁眼眶骨折安全有效，同时采用了两种植入物的优势。

Objective To evaluate the effect of titanium mesh combined with porous polyethylene （Medpor） implantation in orbital reconstruction for medial and inferior orbital wall fractures. Methods The surgical effect of 12 cases（ 12 eyes） of medial and inferior orbital wall fracture patients who received titanium mesh combined with Medpor implantation for orbital wall reconstruction were analyzed retrospectively. Preop- eratively,there were 10 cases with enophthalmos equal to or more than 3 ram,2 cases with enophthalmos be- tween 2 to 3 mm,5 cases with diplopia,2 cases with apparent vertical globe dystopia. For all the cases, an in- ferior subciliary approach was performed, a titanium mesh plate was used for the inferior orbital wall recon- struction and Medpor was used for the medial orbital wall reconstruction or in cases with apparent enophthal- mos. Results Postoperatively, after a followed up period of 3 - 6 monthes,the enophthalmos of all the cases was successfully corrected to less than 2mm, the preoperative diplopia disappeared in 4 cases, resolved appar- ently in 1 case,the vertical globe dystopia of 2 cases disappeared, and no visual acuity impairment was ob- served. No complication of infection, extrusion, rejection or migration of the implants occurred. Conclusion Titanium mesh combined with Medpor implantation in orbital reconstruction for medial and inferior orbital wall fractures is safe and effective, which takes the merits of both implants.