【摘要】 目的　评价自体颅骨移植在治疗面部外伤致眶底缺损中的作用。方法　对 3 4例面部创伤眶底爆裂骨折 (以下简称眶底骨折 )有骨质缺损者 ,采用冠状切口取自体骨 ,结膜切口加外眦切开入路进行骨移植修复缺损。结果　所有病例术后创口愈合良好 ,无感染。供骨区无并发症发生。1例术后 3个月内有轻微下睑外翻 ,通过自行按摩半年后已不明显 ,8例术前有眶下区麻木者 ,术后1～ 6个月全部恢复 ,4例有复视者术后消失。通过半年至 5年 (平均 11个月 )的随诊 ,移植骨成活良好 ,供受骨区切口瘢痕不明显。均取得了满意的临床疗效。结论　自体颅骨移植并发症少 ,对眶底的重建有许多优点 ,是眶底重建的理想移植材料。更多还原

【Abstract】 Objective To evaluate the effects of autogenous calvarial bone grafts on treatment of the patients with defect of orbital floor from facial trauma. Methods\ During a 5 year period from April 1994 to April 1999, 34 patients ranging in age from 16 to 68 years (twenty males and fourteen females), who presented with orbital floor defects associated with other facial fractures were reconstructed by autogenous calvarial bone grafts. The surgical approach to the orbital floor involved a transconjunctival incision in 31 patients and a subciliary incision in 3 patients. After the orbital floor exploration, the bone graft was harvested through the coronal incision in 29 patients and the parietotemporal region incision in 5 patients. The bone graft was then fashioned to the appropriate size and configuration and fixed to the stable bone of the orbital floor with microplates or screws Results\ The surgical incisions healed well with a minimal scar. There were no infection, extrusion or other complications associated with autogenous calvarial bone graft. There were no cases of optic neuropathy, diplopia and enophthalmos. There was no morbidity in donor sites. One patient had slight ectropion, which lasted three months and became inconspicuous in six months. 8 cases with hypoesthesia of the infraorbital region returned the sensory function within 6 months. 6 patients with enophthalmos were partly corrected. The follow- up period ranged from 6 months to 5 years. Conclusion\ The orbital floor defects should be managed by early exploration to avoid later complications. The sequel, such as enophthalmos and dystopia or diplopia are much more difficult to correct after bony union. A vast array of autogenous and alloplastic materials have been used to reconstruct the defect of orbital floor. Autogenous bone graft reduces the risk of infection and extrusion. Cranial bone graft produces less donor site morbidity compared with other sites, non-visible scar as the incision is placed within the hair-bearing skin and the conjunctiva. The membranous bone from the skull has been shown to undergo less resorption and greater graft volume survival as compared to endochondral bone of the iliac crest or rib. Skull bone is an ideal source of bone graft in orbital reconstruction.;更多还原