颧骨复合体骨折伴颅骨缺损的手术治疗

目的 评价颧骨复合体骨折伴颅骨缺损手术治疗的效果.方法 15例颧骨复合体骨折伴颅骨缺损患者接受同期手术治疗,术中采用冠状切口、下睑缘切口及口内切口行颧骨复合体截骨复位,并采用钛网或个性化颅骨修复体修补颅骨缺损,所有患者术前、术后均拍摄双眶轴位及冠状位CT、头面部三维CT并进行比较.结果 术后随访3～7 个月,除1例患者术后3个月颞部轻度塌陷,其余患者颅面部基本对称,颅面部畸形基本消失.结论 颧骨复合体骨折伴颅骨缺损的治疗应以颧骨体的准确复位作为手术成功的关键,颅骨缺损的个性化修复具有推广应用的前景.

Surgical treatment of zygomatic complex fracture combined with cranial bone defect

OBJECTIVE To evaluate the effect of surgical treatment of zygomatic complex fracture combined with cranial bone defect. METHODS Fifteen patients with zygomatic complex fracture combined with cranial bone defect underwent osteotomy and repositioning of the zygomatic complex and cranioplasty in one stage. The coronal, subciliary, intraoral approaches were used. The titanium mesh and individual implants were applied in reconstructing cranial bone defect. Orbital axial CT and coronal CT, three-dimension CT scan have been taken in all the cases preoperatively and postoperatively. RESULTS All patients were followed up from 3 to 7 months. Craniofacial symmetry was achieved postoperatively except that the depression of the temporal region was found in one case at the third month after surgery. CONCLUSION The correct reduction of zygoma was key important for the successful treatment of zygomatic complex fracture combined with cranial bone defect. The application of individual implants provided an ideal and simple method.