摘要
目的:应用计算机辅助技术制作个性化钛网重建眶壁,矫治眼眶骨折继发眼球内陷,并与传统方法对比,评价其治疗效果。方法:20例非单纯性眼眶骨折的患者,男性12例,女性8例。A组8例应用个性化钛网,B组12例应用传统方法。应用图形处理软件,以CT数据为基础,行眼眶三维重建,镜像翻转复制健侧眼眶替代患侧眼眶,应用快速成形技术制作复制后的患侧眼眶的三维模型,在其上成形钛网,手术植入行眶壁重建。通过临床检查和CT测量,并与传统眼眶重建方法对比,评价该方法的治疗效果。结果:术前、术后患侧眼球内陷的差值:A组平均为2.6mm,B组平均为2.0mm;术前、术后患侧眼眶容积扩大量的差值:A组平均为4.3mL,B组平均为3.7mL;术后眶下壁修复指数A组和B组均为100%;眶内壁修复指数:A组为84.7%,B组为53.3%;植入体眶内置入深度:A组平均为31.2mm,B组平均为28.3mm;术后复视相改善情况:A组平均1.5个象限恢复,B组平均1个象限恢复。术后所有病例未出现相关并发症。结论:计算机辅助制作个性化钛网技术在重建眶壁形态、眶壁修复范围和置入深度等方面均优于自体骨、人工材料移植等传统重建方法。应用计算机辅助制作个性化钛网技术可以更加精确地重建眶壁,提高眼球内陷和复视的矫治效果。
Objective： The aim of this study was to develop and assess the computer-assisted fabricated individual titanium mesh technique applied for reconstruction of fractured orbital walls to correct posttraumatic enophthalmus and diplopia. Methods： Twenty patients （12 males and 8 females） were included in this study. All of patients suffered from unilateral impure orbital fractures. Group A included 8 patients who were reconstructed for the fractured orbit with computer-assisted fabricated titanium mesh technique. Group B had 12 patients treated with traditional methods （titanium meshes in 2, autogenous bone grafts in 7 and Medpor implantation in 3 ）. CT data of group A was input into a image software to rebuild a 3-D orbit and then mirror the unaffected side onto the affected side to replace the demolished orbit. A resin model of the reshaped orbit was then produced and was used to develop custom-fabricated titanium mesh for repair of the fractured orbital wall. The fabricated mesh was used in operation to reconstruct the orbital wall. Treatment was assessed in comparison with traditional way by means of clinical examinations and CT measurements. Results： The difference between pre-operative and post-operative enophthalmos： the mean value of group A was 2.6 mm, group B was 2.0 mm ; the difference between the pre-operative and post-operative enlargement volume of traumatic orbit ： the mean value of group A was 4.3 mL, group B was 3.7 mL; Index of Medial orbital wall of both groups was 100% and Index of inferior wall recon- struction of group A was 84.7%, group B was 53.3% ; The mean depth of implants of group A was 31.2 mm, of group B was 28.3 mm ; Improvement of diplopia of group A was 1.5 quadrants, that of group B was 1 quadrant. There were no infection, gaze restriction, or graft extrusion in all patients after operation. Conclusion： Computer-assisted fabricated titanium mesh technique could provide more accu- rate orbital reconstruction and improve the correction of enophthalmus and diplopia.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2008年第1期88-91,共4页
Journal of Peking University:Health Sciences
关键词
眶骨折
眼球内陷
计算机辅助设计
Orbital fractures
Enophthalmos
Computer-aided design
