Clinical Application Of Medpor In Reconstruction Of Blow Out Fracture Of The Orbit

The clinical menifetations of blow out fracture of theorbit are diplopia,decreased myodynamia, endophthalmos,emphysema,et al.The mechanisms of blow out fracture ofthe orbit:(1) theory of the transfer of fluid pressurein orbit;(2)the theory of burke press acting on the bottomof orbit.With the development of traffic and athletics,theincidence rate of blow out of fracture of the orbitincreases gradually.The purpose of treatment is to improvethe cinesipathy of ocular,to correct ambiopia,to anastateacuity of vision and to improve trapment of eyeball.Autologous tissue has the goodnesses ofcompatibility ,easy to take,no rejection,easy to moulding,but has morecomplications;the souse artificial is abundance,and ithas the good quality of not being absorbed by body,beingreceived by operator and patient,but has nothistocompatibility.HAC ( hydroxyapatite ceramic) isporous material after chemical processing,it has the goodquality of vascularizeing quickly ,but it is hard tocarve.In this article,16 cases (16 eyes)of blow out fractureof the orbit from Nov 2003 to May 2005 were restitutedusing Medpor,and were followed up.The checks beforeoperation:CT scanning and three-dimensionalreconstruction, examinations of ophthalmology. Accordingto the dimensionlity of enophthalmos ,we can calculate thevolume to add the volume of Medpor.After local anesthesiaor entire anesthesia ,operater cut-off skin,hypoderm,blunt dissection to periost, cut-off periost full-thickly,reposited the soft tissue that in the antrum highmoric orantrum ethmoidale.We cut Medpor producted by Porex company USA(40.0×52.0×2.3mm),after soaking in hot NS 5-10 minutes, inorder to fit orbit wall.After implanting Medpor,we dilutedorbit using cidomycin,and sewed up layerly.Afteroperation,we changed of dressing ruly, quiescented pointantibiotics and glucocorticoid 3-5 days.Result:Beingfollowed up for 1-3 years,average 1.6 years. Ambiopia:of11 cases,9 cases were healed,accounting 81.8%,2 caseswere imporved,accounting 18.2%.Enophthalmos: 12 caseswere healed, accounting 92.3%,1 case was correctinsufficiently, accounting 7.7%. The differenceexophthalmos between injuried eyes and healthy eyes is+1.0 ～ -2.0mm , average -0.6mm 。 Of the 12 cases oflimitation of movement,10 cases were completelyrecoveried,accounting 83.3% , 2 cases were obviouslyimproved,accounting 16.7%.No case happened rejection orinfection.Being followed up for 3 months -3 years,no anycomplication (the exodus,shift, absorb ,abnormity ofinsert) was happened.The characteristic of Medpor:Medpor is symthesesed bybiology transplantment. It can be vascularized,anti-infection,not be absorbed, invariance , goodness ofbilcompatibility ,and has no tissue reaction and so on.Wecan obtain the conclusion from the cases of this group :we should select suitable opportunity to restituteorbit after blow out of fracture of orbit,and the fillnessof suitable materials can improve enophthalmos,movingdown,ambiopia,cinesipathy of eyeball,improving appea-rance obviously;Medpor has the good qualities of easyentering of fiber blood vessel, anti-infection,highintensity,withstand voltage, anti-tireeness,no absor-ing,invariance, has no reaction of soft tissue and hasthe goodness of biocompathbility. It is an ideal insertmaterials in restitution of orbit wall, it is safe andutility,worth to extend and applied. The restitution oforbit with the implantment of Medpor is safe and reliable,is the utility operation to treat blow out of fracture ofthe orbit.