Treatment of orbital floor fracture using a periosteum-polymer complex
Treatment of orbital floor fracture using a periosteum-polymer complex
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DOI：
10.1016/j.jcms.2009.06.011
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发表时间：
2010-04-01
影响因子：
3.1
通讯作者：
Isogai, Noritaka
中科院分区：
文献类型：
--
作者：
Asamura, Shinichi;Ikada, Yoshito;Isogai, Noritaka
各种修复眼眶底骨折骨缺损的材料已被开发并应用于临床。近年来，用聚合物替代自体骨和人工材料进行骨修复已被积极提出，但存在可重建骨缺损的大小和聚合物的分解率等问题。通过将骨膜附着到可生物降解的聚合物薄片上而产生的骨膜聚合物复合体，进行了骨再生的基础研究。本研究对近3年来眼眶底骨折患者采用羟基磷灰石-[聚(L-丙交酯-异丙交酯-己内酯)](HA-P(CL/LA))骨膜聚合物复合体和髂骨重建眶底骨缺损进行了临床评价。面积小于2.5 cm(2)的定义为小型，2.5~4 cm(2)定义为中度，大于4 cm(2)定义为大型。对于较小的骨缺损，骨膜聚合物复合体组和髂骨组各有一名患者眶下神经感觉减退。两组患者均有1例出现眶下神经复视和感觉减退。对于较大的骨缺损，骨膜聚合物复合体组和髂骨组各有1例复视，前者仅有1例眶下神经感觉减退。所有患者的眼球内陷均未超过2 mm。使用骨膜聚合物复合体进行手术治疗后，眼球的解剖位置和眼球运动正常，就像使用自体骨重建一样。(C)2009年欧洲颅颌面外科协会
Various materials for the reconstruction of bone defects in orbital floor fractures have been developed and applied clinically. Recently, reconstruction using polymers, in place of autologous bone and artificial materials, has been actively introduced, but there are problems, such as the size of reconstructable bone defects and the decomposition rate of polymers. A basic study was performed on bone regeneration using a periosteum polymer complex produced by attaching periosteum to a biodegradable polymer sheet. In this study, patients with orbital floor fractures were evaluated clinically who had undergone reconstruction of orbital floor defects of the using a periosteum polymer complex produced by applying periosteum to an Hydroxyapatite-[poly (L-lactide-epsilon-caprolactone)](HA-P (CL/LA)) sheet and the ilium in the previous 3 years. A bone defect of less than 2.5 cm(2) area was defined as small, that of 2.5-4 cm(2) as intermediate, and that of more than 4 cm(2) as a large bone defect. For small bone defects, hypoaesthesia in the infraorbital nerve was observed in one patient each of the periosteum polymer complex and ilium groups. Regarding intermediate bone defects, diplopia and hypoaesthesia in the infraorbital nerve were observed in one patient in each of the two groups. For large bone defects, diplopia was observed in one patient each for the periosteum polymer complex and ilium groups, and hypoaesthesia of the infraorbital nerve was only detected in one patient of the former group. Not more than 2 mm of enophthalmos was detected in any patient. The anatomical eyeball position and eyeball movement were normal after surgical treatment using the periosteum polymer complex, just as in reconstruction using autologous bone. (C) 2009 European Association for Cranio-Maxillo-Facial Surgery