目的:总结分析我中心2008-2017年中国眼眶近视患者行开箱截骨术的术后并发症。
方法:这项回顾性研究回顾了78例具有完整病历和至少2年术后随访数据的患者的记录。之前进行了放射学和人体测量评估,术后1个月和术后2年评估骨和软组织改变。记录住院期间和每次随访时的术后并发症,分为3组:术后1个月内发生的急性并发症;术后6个月内发生的早期并发症;以及术后2年内发生的长期并发症。
结果:骨性和软组织的改变在手术后1个月都是显著的。我们中心发生的急性并发症包括感染(12.8%),脑脊液漏(29.5%),癫痫(2.6%),鼻尖皮肤坏死(1.3%)。早期并发症包括斜视(11.5%)和鼻泪管阻塞(3.8%)。长期并发症包括矫正不足(55.1%),可触及的金属植入物(92.3%)和下垂的鼻尖(33.9%)。由于校正不足和肋骨移植物的持续增长,远觉指数和鼻长的差异,术后1个月至2年有统计学意义(P<0.01)。其他影像学和人体测量学测量结果随生长而变化,术后1个月和2年之间没有显着差异。
结论:在这项研究中,我们记录了开箱移位截骨术的所有术后并发症。我们未来工作的挑战是确定降低这些并发症发生率的方法。
OBJECTIVE: To summarize and analyze the postoperative complications of box-shift osteotomy performed at our center for Chinese orbital
hypertelorism patients from 2008 to 2017.
METHODS: This retrospective study reviews the records of 78 patients with complete medical records and at least 2 years of postoperative follow-up data. Both radiologic and anthropometric assessments were conducted before, 1 month after and 2 years after surgery to evaluate the bony and soft-tissue alterations. Postoperative complications were recorded during hospitalization and at each follow-up visit and divided into 3 groups: acute complications that occurred within 1 month after surgery; early complications that occurred within 6 months after surgery; and long-term complications that occurred within 2 years after surgery.
RESULTS: Both bony and soft-tissue alterations were significant at 1 month after surgery. The acute complications that occurred in our center included infection (12.8%), cerebrospinal fluid leakage (29.5%), epilepsy (2.6%), and nasal tip skin necrosis (1.3%). The early complications included strabismus (11.5%) and nasolacrimal duct obstruction (3.8%). The long-term complications included insufficient correction (55.1%), palpable metal implants (92.3%) and a drooping nasal tip (33.9%). Due to the insufficient correction and the continued growth of rib graft, the difference in the
hypertelorism index and nasal length, between one month and 2 years postoperatively were statistically significant (P < 0.01). Other radiographic and anthropometric measurements changed with growth without a significance difference between 1 month and 2 years after surgery.
CONCLUSIONS: In this study, we recorded all postoperative complications of box-shift osteotomy. The challenge of our future work is to identify methods for decreasing the incidence of these complications.