Treacher-Collin综合征颧眶骨再造术

Malar reconstruction in the patients with Treacher-Collin's syndrome

目的 探讨以颧眶骨整复再造治疗Treacher Collin综合征 ,并对各种充填材料进行临床比较研究。方法 1994～ 2 0 0 2年 ,采用冠状切口或下睑缘和上睑带蒂皮瓣局部进路 ,眼眶外下部、颧骨体及颧弓部骨膜下剥离 ,应用不同材料进行眶、颧弓再造治疗Treacher Collin综合征 5 5例。结果 所有病例颧骨再造均获成功 ,眶外下部分得到修复 ,外形满意率达 90 % ,无感染 ,再造材料局部外露 2例 ,外形二期修整 1例。结论 颧眶部再造是Treacher Collin综合征治疗的基础和最重要部分 ,自体骨为最常用的颧眶骨再造材料 ,Medpor是理想的人工材料 ,组织相容性好 ,无排异 ,无吸收复发 ,可以避免采骨供区损伤。

Objective The key feature of Treacher-Collin's syndrome is malar dysostosis.The article focused on malar reconstruction for Treacher-Collin's syndrome and compared the implant materials. Methods From 1994 to 2002,a total of 55 patients with Treacher-Collin's syndrome were treated with malar reconstruction.In the operation,the lateral orbital rim and the mala were exposed by the bicoronal incision or the subciliary incision.The mala was augmented and reconstructed with implants of different materials,including autologous bone(rib,ilia or cranium),Medpor biomaterial or bone cement. Results The operations of the 55 patients were all successful without infection.The satisfactory rate in facial contour was 90%.Implant exclusion occurred in 2 cases using bone cement. Conclusion Malar reconstruction is the most important treatment for Treacher-Collin's syndrome.Every implant material has advantages and shortcomings.Autologous bone is the best material for malar reconstruction.Medpor is the best artificial material,with good histocompatibility,without exclusion,absorption and donor injury.