■眼眶骨骼的成功修复通过使眼球位置正常化并使眼外肌完全运动来恢复功能和美容。常规修复是成功的标准植入物。然而,不规则或导致体积不足的缺陷可能难以修复。患者特异性植入物(PSI)的开发在复杂情况下提供了额外的工具。在这里,我们报告了我们使用PSI进行轨道重建的经验。
■对2016年8月至2018年9月接受PSI的连续患者进行了IRB批准的审查。记录人口统计学和检查结果。PSI使用高密度多孔聚乙烯或聚醚醚酮(PEEK)设计并植入修复。对术后病程进行评估,了解结果和并发症。
■确定了8名患者。两个人患有无声窦综合征,3例面部复杂骨折翻修,和3个是肿瘤后重建。七个收到多孔聚乙烯植入物,1有PEEK植入物。平均随访时间为10.2个月(3.3~28.3)。所有都具有改进的功能和美学效果。在60%的骨折和无症状窦患者中,复视和眼球内陷完全解决。所有骨折和无声窦患者在最后一次随访中的主要凝视均为正交性,无复视。肿瘤患者在对称性和功能性方面有所改善。没有并发症。
■复杂的眼眶骨骼错乱可能难以修复,标准植入物可能无法完全解决解剖问题。在具有挑战性的案例中,PSI可以更好地实现美学和解剖学上的成功结果并改善功能。
UNASSIGNED: Successful repair of the orbital skeleton restores function and cosmesis by normalizing globe position and allowing full motility of the extraocular muscles. Routine repairs are successful with standard implants. However, defects that are irregular or cause volume deficiency can be challenging to repair. The development of patient specific implants (PSI) offers an additional tool in complex cases. Herein, we report our experience using PSI for orbital reconstruction.
UNASSIGNED: An IRB-approved review was conducted of consecutive patients who received PSI from 8/2016-9/2018. Demographic and examination findings were recorded. PSI was designed using high-density porous polyethylene or polyetheretherketone (PEEK) and implanted for repair. The postoperative course was reviewed for outcomes and complications.
UNASSIGNED: Eight patients were identified. Two had silent sinus syndrome, 3 were complex facial fracture revisions, and 3 were post-oncologic reconstruction. Seven received porous polyethylene implants, and 1 had a PEEK implant. Mean follow up time was 10.2 months (3.3-28.3). All had an improved functional and aesthetic result. Diplopia and enophthalmos completely resolved in 60% of fracture and silent sinus patients. All fracture and silent sinus patients were orthotropic without diplopia in primary gaze at last follow up. Tumor patients had improvement in symmetry and functionality. There were no complications.
UNASSIGNED: Complex orbital skeleton derangements can be difficult to repair and standard implants may incompletely resolve the anatomic problem. In challenging cases, PSI may better achieve an aesthetically and anatomically successful outcome and improve functionality.