颞浅筋膜瓣旋转充填联合HA眼座植入术——眼球摘除术后眶窝凹陷的治疗

目的 探讨颞浅筋膜瓣旋转充填联合羟基磷灰石（hydroxyapatite,HA）眼座植入治疗因视网膜母细胞瘤行眼球摘除联合放疗后眶窝凹陷畸形的效果及临床价值。方法 5例5眼先行HA眼座植入，同时，制作以颞浅动、静脉为蒂的颞浅筋膜瓣，经皮下隧道旋转充填于眶内，覆盖HA眼座上，再分层缝合眼球主球结膜。术后半年行结膜囊成形术，配载超薄义眼壳。结果 全部病例随访超过6月，术后眶窝凹陷全部改善。移植粘膜行结膜囊成形术后配载义眼壳改观显著，粘膜移植全部成活。结论 颞浅筋膜瓣旋转充填联合HA眼座植入治疗因视网膜母细胞瘤行眼球摘除联合放射治疗后眶窝凹陷，不仅可以明显改善凹陷，而且可以改善局部的血供，为以后进行粘膜移植结膜囊成形术打下良好的基础。

The superficial temporal fascia grafting with hydroxyapatite sphere for orbital implantation - The treatment for the sunken orbital cavity after enucleated of eyeball

Objective To explore the effect and the clinical value of the treatment of the sunken orbital patients with retinoblastoma who had enucleated eyeball and received radiation by the superficial temporal fascia grafting with hydroxyapatite sphere for orbital implantation. Methods Five cases (5 eyes) were selected of the patients. The first, HA sphere was implantated in the orbital cavity then a superficial temporal fascia flap was made and transplanted to the surface of HA shpere through the hypodermic tunnel. At last, we row the fascial sheath of bulb and the bulbar conjunction were sutured. 6 months later, these patients were fixed the super lamella prosthetic eye after received plastic operation of conjunctival sac. Results The follow-up examination was more than 6 months. The sunken orbital cavity was lessened. Having received plastic operation of conjunctival sac with mucosa transplanting, the patients fixed the prosthetic eye looked matamorphic obviously and the transplanted mucosa kept alive.Conclusion The treatment not only can lessen the sunken orbital, but also improve the blood-supply in preparation for the next plastic operation of conjunctival sac with mucosa transplantation.