| Objective : Orbital blowout fracture is orbital contusion common injury. Orbital diameter greater than from the mouth of blunt objects against orbital soft tissue and orbital caused orbital weakest department burst orbital soft tissue strangulated hernia one of the paranasal sinuses, causing enophthalmos and displacement, ocular motility disorders and diplopia and infraorbital nerve sensory loss syndrome in a group.To present the clinical right orbital blowout fracture of the surgical timing controversy, Clinical work often see many patients for a variety of reasons for the delay caused enophthalmos. diplopia and eye movement disorders. The experimental use of immunohistochemical methods to detect orbital blowout fracture, at different times of trauma surgery at the Department is involved in the repair and fibrosis of various factors change, Surgical treatment for clinical provide the exact timing of surgery.Methods: Dalian City Center Hospital Eye for orbital blowout fracture reconstructive surgery, fractures in the surrounding soft tissue (muscle, tissue, etc.) injured by the day after surgery to post-traumatic time for a length. 7 days after injury within 24 patients (group A), 8-14 days after injury in 24 patients (group B), injured after 15 days in 12 patients (group C), a total of 60 cases. Histopathology testing : 10% neutral formalin-fixed specimens of 24h, the conventional dehydration, paraffin- embedded, 5 mm thick consecutive sections were performed immunohistochemical staining, and microscopic observation. Immunizations used technique to detect fractures in different time after surgery, from fractures and soft tissue around the wound repair with close ties to the peptide growth factors : the expression of(transforming growth factor-beta )TGF-β,(platelet derived growth factor)PDGF,(vascular endothelial growth factor)VEGF gives out statistical analysis of orbital fracture scar formation and the degree of fibrosis.Results : The injury factor in the three different periods (that is different) comparison : TGF-beta : A, B, C group had significant difference (H=16.731, P = 0.000). PDGF:B A, C between the two groups have significantly different, and A, C between the two groups no significant difference (no difference, H=3.568, P=0.168). VEGF:A, B and C among the three groups had significantly different (H=16.468, P = 0.001)Conclusion :1.Orbital blowout fracture injury after initial fracture soft tissue TGF-beta, increased expression of PDGF, and VEGF expression was relatively small, with different time after the cytokine expression significant difference. Orbital blowout fracture reduction surgery should be the best time for surgery choose not fracture the surrounding scar formation, neovascularization less, or injured after seven days.2.After 8-14 days of traumatic fracture soft tissue of TGF-beta and gradually reduce the expression of PDGF, VEGF expression is more, three factor and the initial trauma significant difference. Neovascularization active, the initial formation of scar can still surgery, preoperative and postoperative orbital hematoma is a risk.3.After injury for more than 15 days, more VEGF expression, and the initial trauma of VEGF expression significant difference between TGF-beta. Expression of PDGF reduced orbital fracture scar has been formed, during and after orbital increased risks of bleeding, may form muscle fibrosis occurred restrictive strabismus.
|
PDF Full Text Request