鼻内镜辅助下Medpor Titan植入治疗眶壁骨折的临床研究

目的：探讨鼻内镜辅助下经结膜切口联合Medpor Titan植入行眼眶壁骨折整复的临床疗效。

方法：对16例16眼外伤导致的眼眶内壁、下壁、内下壁骨折患者，鼻内镜辅助下经泪阜结膜切口、下穹窿结膜切口、泪阜联合下穹窿结膜切口径路分离暴露骨折区，将嵌入副鼻窦的直肌、眶脂肪还纳眶内，Medpor Titan材料修补骨折缺损区。观察术后视力、眼球突出度、眼球运动、复视情况、眼眶CT。

结果：患者16例16眼中，术后观察3mo，所有患眼视力无下降，眼球内陷矫正，眼球运动无明显受限，复视消失，眼眶CT 植入物位置满意，未见植入物移位脱出。

结论：鼻内镜下经结膜切口联合Medpor Titan植入行眼眶壁骨折整复术，具有直视操作、骨折范围暴露清晰且手术安全可靠等优点，既恢复了患者的视功能和外观，又减少了并发症的发生，同时也避免术后遗留面部瘢痕，是临床上一种安全、有效的手术方法。

Clinical study of Medpor Titan implantation for orbital blowout fracture with nasal endoscopy

AIM: To investigate the clinical effect of reconstruction of orbital blowout fracture by conjunctival incision combined with Medpor Titan implantation under nasal endoscopy.

METHODS: Sixteen patients(16 eyes)diagnosed with orbital blowout fracture, include medial fractures, floor fractures and extended fractures, were performed reconstruction by transconjunctival approach with implant material- Medpor Titan under nasal endoscopic-assisted; observation of postoperative visual acuity, eyeball protrusion, extraocular movement limitations, diplopia, orbital CT, occurrence of implanted material rejection was taken.

RESULTS: A 3-month follow-up was performed and the therapeutic efficacies of anatomic and functional recovery were evaluated. No further vision loss or infection occurred postoperatively. In the 16 patients, the average postoperative observation was 3mo, enophthalmos were fully corrected, diplopia disappeared. Orbital(CT)did not reveal implant displacement and rejection postoperatively.

CONCLUSION: Endoscopic-assisted reconstruction of orbital blowout fracture by conjunctival incision combined with Medpor Titan implantation is a safe and effective surgical method with the characteristics of with direct operation, clear range of fracture exposure and safe and reliable operation, not only restores the patient''s visual function and appearance, but also reduces the incidence of complications, avoiding postoperative facial scar.