Dermis Fat Grafts as Primary and Secondary Orbital Implants
Dermis Fat Grafts as Primary and Secondary Orbital Implants
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DOI：
10.3109/01676830.2013.844172
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发表时间：
2014-01-01
期刊：
影响因子：
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通讯作者：
Hintschich, Christoph
中科院分区：
文献类型：
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作者：
Nentwich, Martin M.;Schebitz-Walter, Kirsten;Hintschich, Christoph
本研究旨在评估大样本自体真皮-脂肪移植[DFG]眶内植入术后的疗效。材料和方法：对16年期间的所有原发性和继发性DFGs进行回顾性图表回顾。对美观、功能、患者满意度及术后并发症进行评价。结果：研究期间共进行了468例DFGs（一级[I度]315例，二级[II度]153例）。在分析中，由于随访充分，纳入了173个DFG I度和66个DFG II度。DFG I度术后中位随访时间为21.5个月，DFG II度术后中位随访时间为14个月。在DFG I度后，76%的患者可以在所有方向上运动移植物；81%的人对义肢吻合良好，83%的人对结果非常满意。睑孔平均宽度比同侧小0.2mm， Hertel眼测术显示手术侧平均眼内陷1.6mm。在DFG II度后，34%的患者可以在各个方向运动。49%/41%的患者对假体的拟合良好/合理，57%的患者对假体非常满意。平均而言，手术侧睑孔缩小0.6mm， Hertel测量显示眼球内陷2.6mm。主要并发症不常见。II度DFG（6.1%）比I度DFG（3.5%）更常观察到种植体完全坏死。讨论：在这个大样本中，DFG被证明是一种有效和安全的重建眼窝的方法。
Introduction: This study was performed to evaluate the outcome after autologous dermis-fat graft [DFG] orbital implants in a large sample.Materials and Methods: A retrospective chart review of all primary and secondary DFGs in a 16-year period was done. Aesthetic and functional results, patients' satisfaction and postoperative complications were evaluated.Results: In total 468 DFGs were performed in the study period (315 primary [I degrees] and 153 secondary [II degrees] DGFs). In the analysis, 173 DFG I degrees and 66 DFG II degrees were included as sufficient follow-up was available. Median follow-up after DFG I degrees was 21.5 months and 14 months after DFG II degrees. After DFG I degrees, in 76% of patients motility of the graft was possible in all directions; 81% had good fitting of the prosthesis and 83% were highly satisfied with the results. Mean width of palpebral apertures was 0.2mm smaller and Hertel exophthalmometry revealed a mean enophthalmus of 1.6mm on the operated side compared to the fellow-eye. After DFG II degrees, motility was possible in all directions in 34% of patients. Fitting of the prosthesis was good/reasonable in 49%/41% and patients were highly satisfied in 57%. On average, on the operated side palpebral apertures were 0.6mm smaller and Hertel measurements showed an enophthalmus of 2.6mm. Major complications were uncommon. Complete necrosis of the implant was more often observed after II degrees (6.1%) than after I degrees DFG (3.5%).Discussion: In this large sample, DFG proved to be an effective and safe method for the reconstruction of anophthalmic sockets.