Computer-Assisted Volumetric Analysis and Quantitatively Anophthalmic Orbit Reconstruction With Dorsalis Pedis Flap and Bone Graft
| Autor: | Weiwei Bian, Rong Jin, Xiaoming Sun, Liying Cheng, Lu Zhang, Zhe-Yuan Yu, Yuguang Zhang, Ying Zhang |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
genetic structures
Dorsalis pedis flap medicine.medical_treatment Surgical Flaps 03 medical and health sciences 0302 clinical medicine medicine Humans Postoperative outcome Canthus Orthodontics Bone Transplantation Eye Artificial business.industry Anophthalmos Soft tissue Skin Transplantation 030206 dentistry General Medicine Plastic Surgery Procedures eye diseases medicine.anatomical_structure Surgery Computer-Assisted Otorhinolaryngology Eye prosthesis 030221 ophthalmology & optometry Skin grafting Surgery sense organs business Orbit Facial symmetry Orbit (anatomy) |
| Zdroj: | Journal of Craniofacial Surgery. 29:358-363 |
| ISSN: | 1536-3732 1049-2275 |
| DOI: | 10.1097/scs.0000000000004209 |
| Popis: | Current approaches to orbit reconstruction are based on the assumption of facial symmetry and surgeons' experiences, and the reconstructed orbits are not precise. Through computer-assisted volumetric quantitative analysis, the volume of the bony orbit, and the volume of the soft tissues in both the anophthalmic orbit and the contralateral orbit are calculated in 39 anophthalmic patients. The rib graft is used for orbit reconstruction; the dosalis pedis flap and lipo-injection were used for soft tissue reconstruction and skin socket reconstruction. The size and the shape of the rib graft and soft tissues were designed according to the volumetric analysis. The size and the shape of the skin socket were designed according to measurement during surgery. Asymmetry eye sockets with adequate size were created in the 37 patients. Two patients presented with a poor asymmetry with the contralateral orbit, and got gradual extrusion of the eye prosthesis 4 months after operation, which was because of necrosis of the flaps. The flaps were remedied by frontal island flap and skin grafting. Further surgeries, such as lipoinjection, lid surgery, and canthoplasty, were applied to improve the surgical results. The eye prostheses fitted well in all of the reconstructed sockets using this technique. Our studies suggest that the computer-assisted volumetric analysis technique combined with quantitative bone graft and dorsalis pedis flap transfer, ± lipoinjection proved to be an accurate method and a quality assurance for optimization of bony orbit, soft tissue and skin socket reconstruction, and promised a successful postoperative outcome for patients' functional and esthetic appearance. |
| Databáze: | OpenAIRE |
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