Reconstruction of the defect of orbital blowout fractures by hydroxyapatite bone substitute and rehabilitation of ambiopia and the ophthalmic kinesic function

doi:10.3321/j.issn:1673-8225.2003.26.013

Abstract：AIM:Through measuring the changes of orbital volume pre-and post-operatively,to investigate the reconstructive surgical procedures of enophthalmos and orbital skeletal defects by implanting hydroxyapatite bone substitute in patients with orbital blowout fracture and evaluate the effect on rehabilitation of eye movement.METHODS:All the 11 patients with orbital blow-out fracture came from the inpatients in Center of Cranio-Maxillofacial Surgery,Sun-Yat Sen University from 1997 to 2000 with 6 males and 5 females,aged 18- 42 years.The features of orbital deformities,the changes of orbital volume and the mechanisms of enophthalmos in 11 patients with orbital blowout fractures were analyzed by means of three-dimensional computer-assisted diagnostic and design system.The reconstructive operations were employed on these 11 patients with orbital blowout fractures to correct deformities and restore orbital volume by implanting autogenous bone grafts or hydroxyapatite bone substitutes.Hydroxyapatite bone substitute was implanted to reconstruct the orbital bony defect and improve the eye movement.RESULTS:Preoperatively the deviation of orbital volumes between normal and traumatic side was (9.2± 2.8) cm3,which showed a significant difference between two sides(t=9.740,P< 0.05) .Post-operatively the deviation was (0.54± 0.18) cm3,there was not a significant difference between them (P >0.05).There were not serious complications such as infection of bone graft,exposure of hydroxyapatite implant in all patients.Of these 11 patients,10 patients got satisfactory appearance of eyelids and orbit,of which the diplopia and enophthalmos were corrected,with eye movement function restoring normally. One patient remained diplopia after surgical correction.CONCLUSION:Implanting autogenous bone grafts and hydroxyapatite bone substitutes to restore orbital volume and releasing entrapped extraocular muscles were proved to be effective for improving eye movement function and ambiopia after fracture.