摘要：

目的: 探讨计算机导航结合个性化钛网进行颧上颌复合体(zygomaticomaxillary complex, ZMC)伴眶壁骨折修复重建手术的临床效果。方法: 回顾性分析2018年6月—2020年12月我院收治的6例ZMC伴眶壁骨折患者的临床资料,所有患者均应用计算机导航及个性化钛网进行骨折修复重建手术。测量术前、术后健侧与患侧的眶容积,并采用配对t检验比较术前、术后健侧与患侧的眶容积差。术后常规复查,对瞳孔位置、复视情况、伤口愈合情况、面部外观及相关功能进行评价并随访, 术后随访3~12个月。结果: 术前健侧与患侧的眶容积差为(5.25±2.34) mL,术后健侧与患侧的眶容积差为(1.98±1.21) mL,两者差异有统计学意义(P<0.05);术后复视情况为5例治愈,1例好转;所有患者术前均有不同程度的瞳孔位置变化及眼球运动功能障碍,术后所有患者瞳孔位置变化及眼球运动功能障碍均得到明显改善;所有患者手术创口愈合良好,均未出现神经损伤、感染、植入体排斥等并发症,患者对术后外形、功能恢复满意。结论: 计算机辅助手术导航结合个性化钛网进行ZMC伴眶壁骨折修复重建是一种精确、可行的方法,可以精确恢复眶壁解剖形态及眶容积,明显改善患者复视及眼球运动障碍,使眶部功能和感觉得到较好的维护,患者面部外形也得到恢复。

关键词: 计算机导航, 钛网, 颧上颌复合体骨折, 眶壁骨折

Abstract:

Objective: This study was intended to explore the effects of computer-aided navigation combined with personalized titanium mesh in the reconstruction of fractures of zygomaticomaxillary complex (ZMC) complicated with orbital wall. Methods: The clinical data of 6 patients with ZMC complicated with orbital wall fracture treated in our hospital from June 2018 to December 2020 were retrospectively analyzed. Computer-aided navigation and personalized titanium mesh for ZMC with orbital wall fracture reconstruction were applied in all cases. The orbital volumes of the healthy and affected sides before and after surgery were respectively measured and the preoperative and postoperative orbital volume differences between healthy and affected sides were compared using paired t-test. For postoperative routine examinations, the pupil position, diplopia, wound healing, facial appearance and their related functions were evaluated and all patients were followed up for 3-12 months postoperatively. Results: The preoperative orbital volume difference between the healthy and affected sides was (5.25±2.34) mL and the postoperative one was (1.98±1.21) mL with significant statistical difference (P<0.05). The cure situation of diplopia after operation: 5 cases were cured and 1 case was improved. All patients had varying degrees of pupil position changes and eye movement dysfunction before surgery, but situations were significantly improved in all patients after surgery. All patients had uneventful wound healing, and no complications such as nerve injury, infection and implant rejection occurred with satisfactory recovery of appearance and function after operation. Conclusion: Computer-aided navigation combined with personalized titanium mesh in reconstruction of fractures of ZMC complicated with orbital wall is a more accurate and feasible method, which can accurately restore the anatomical shape and orbital volume of orbital wall, significantly improve diplopia and eye movement disorder, make the orbital function and feeling better maintained. The facial contour of the patient was also restored.

Key words: computer-aided navigation, titanium mesh, zygomaticomaxillary complex fracture, orbital wall fracture

中图分类号: 

• R782