眼眶爆裂性骨折Medpor钛网种植体早期整复

Medpor titanium mesh implants for the early restoration of orbital blowout fracture

目的 探讨Medpor钛网种植体在眼眶爆裂性骨折伴眼球内陷的早期整复手术中的疗效.方法 对18例眼眶爆裂性骨折合并有眼球内陷,外伤后2周施行眼眶修复术,以Medpor钛网种植体作为整复材料,三维CT扫描测量术前眼眶容积变化;Hertel眼球突出计测量术前、术后眼球内陷的程度;所有测量均以对侧正常眼为对照;术后随访6 ～ 12个月.结果 18例眼眶爆裂性骨折眼眶容积较对照眼均有明显增大（t=-20.54,P＜0.01）;术后眼球内陷均矫正,术后6个月11例复视消肖失,2例复视症状改善,复视治愈率84.61％.结论 通过三维CT及计算机辅助技术对眼眶爆裂性骨折伴眼球内陷做早期诊断,早期重建手术疗效好;Medpor钛网种植体在眼眶整复术中是安全、有效的.

Objective To study the effect of the Medpor titanium mesh implants for the early restoration of orbital blowout fracture with enophthalmos.Methods The Medpor titanium mesh implants and orbital repair surgery was performed in 18 cases with orbital blowout fracture and enophthalmos 2 weeks after trauma,and the changes in orbital volume before surgery was measured by three-dimensional CT scan.The enophthalmos degree before and after operation was measured by Hertel proptosis meter in preoperation and postoperation.All measurements of normal contralateral eyes were as control.Patients were followed up for 6 to 12 months.Results The orbital volume of 18 cases with orbital blowout fracture increased significantly compared with that of the control eyes （t =-20.54,P 〈 0.01）.The enophthalmos were all corrected after surgery.After 6 months,diplopia disappeared in 11 cases and was improved in two cases and the cure rate was 84.61% （11/13）.Conclusion Early reconstruction surgery through computer-aided three-dimensional CT technology is more effective for orbital blowout fracture with enophthalmos and the Medpor titanium mesh implant is safe and effective.