흡수성과 비흡수성 안와 내 삽입물을 이용한 안와 내벽골절수술결과: 비교 연구
Reconstruction of Orbital Medial Wall Fracture with Absorbable and Non-Absorbable Orbital Implant: Comparative Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 안와 내벽골절 수술에 있어 비흡수성 삽입물인 porous polyethylene (MedporⓇ, Stryker Instruments, Kalamazoo, Michigan, USA)과 흡수성 삽입물인 polyglycolic acid (PGA), polylactic acid (PLA)의 중합체(Mesh plateⓇ, Inion Ltd, Tampere, Finland)의 수술결과, 합병증에 대해 비교하고자 한다. 대상과 방법: 2007년 1월부터 2012년 6월까지 안와 내벽골절 수술을 받은 환자를 대상으로 사용한 삽입물(MedporⓇ, Mesh plateⓇ)에따라 두 군으로 나누어 후향적 의무기록 조사를 하였다. 결과: 86명의 환자 중 37명은 MedporⓇ를, 49명은 Mesh plateⓇ를 이용해 수술하였다. 수술 후 6개월째 안구운동장애, 복시 모두 두군 간의 차이를 보이지 않았다(Fisher’s exact test, p=0.192, p=0.128). 양안의 안구돌출계 차이의 평균은 MedporⓇ를 사용한 군에서0.49 ± 1.04 mm, Mesh plateⓇ를 사용한 군에서 0.37 ± 0.62 mm로 유의한 차이를 보이지 않았다(Independent t-test, p=0.512). MedporⓇ를 사용한 환자 중 3명에서 삽입물 주변의 염증, 삽입물의 위치이상 등의 합병증이 관찰되었다. 결론: 안와 내벽골절의 수술에 있어 MedporⓇ와 Mesh plateⓇ 간에 수술 6개월째의 결과에는 차이가 없는 것으로 보이며, 다만MedporⓇ를 사용한 환자 중 3명에서 합병증을 보였다.
Abstract
Purpose: To compare the surgical results and complications of medial wall fracture reconstruction using non-absorbable porouspolyethylene implants (Medpor®, Stryker Instruments, Kalamazoo, Michigan, USA) and an absorbable polymer of polyglycolicacid (PGA) and polylactic acid (PLA) (Mesh plate®, Inion Ltd, Tampere, Finland). Methods: We retrospectively reviewed the data of patients who underwent reconstruction of medial wall fracture betweenJanuary 2007 and June 2012 and divided them into 2 groups according to orbital implant type (Medpor®, Mesh plate®). Results: Among the 86 patients, 37 were treated with Medpor® and 49 with Mesh plate®. There was no statistically significant differencein limitation of motion or diplopia score between the 2 groups at postoperative 6 months (Fisher’s exact test, p = 0.192,p = 0.128, respectively). Mean postoperative exophthalmometry differences between the eyes were 0.49 ± 1.04 mm and 0.37 ±0.62 mm in Medpor® and Mesh plate® groups, respectively, showing no statistically significant difference (independent t-test, p =0.512). Postoperative complications such as inflammation or implant malposition were observed only in 3 patients in the Medpor®group. Conclusions: No difference was observed between Medpor® and Mesh plate® in terms of surgical results during the postoperative6 month period after reconstruction of orbital medial wall fracture. However, postoperative complications were observed in 3 patientsin the Medpor® group.
참고문헌 (21)
- 임헌섭, "생체 흡수성 코폴리머 고정판을 이용한 안와골절 정복술의 결과", 대한안과학회지, 50(12), pp.1761~1767 (2009), 대한안과학회
- 전찬, "다공성 폴리에틸렌", 티타늄 삽입물을 이용한 안와골절의 치료, 2009, pp.50(8), 1133~1140[DOI]
- 지미정, "생체 흡수성 코폴리머 고정판을 이용한 안와골절의 치료", 대한안과학회지, 47(7), pp.1021~1030 (2006), 대한안과학회
- Avashia YJ, "Materials used for reconstruction after orbital floor fracture", The Journal of Craniofacial Surgery, 23, pp.1991~1997 (2012)
- Han DH, "Comparison of the outcomes of blowout fracture repair according to the orbital implant", The Journal of Craniofacial Surgery, 22, pp.1422~1425 (2011)
- Dietz A, "Effectiveness of a new perforated 0.15 mm poly-p-dioxanon-foil versus titanium-dynamic mesh in reconstruction of the orbital floor", J Craniomaxillofac Surg, 29, pp.82~88 (2001)
- plate, "J Oral Maxillofac Surg", 2006, 1038~1048
- Kim YJ, "Open reduction in trapdoor-type blowout fractures using absorbable mesh plates", The Journal of Craniofacial Surgery, 22, pp.2264~2267 (2011)
- Hwang K, "Comparison of the supporting strength of a poly-L-Lactic acid sheet and porous polyethylene (Medpor) for the reconstruction of orbital floor fractures", The Journal of Craniofacial Surgery, 21, pp.847~853 (2010)
- Kontio RK, "Reconstruction of internal orbital wall fracture with iliac crest free bone graft: clinical, computed tomography, and magnetic resonance imaging follow-up study", Plast Reconstr Surg, 118, pp.1365~1374 (2006)
- Kraus M, "Repair of traumatic inferior orbital wall defects with nasoseptal cartilage", J Oral Maxillofac Surg, 59, pp.1397~1400 (2001)
- Krishnan V, "Orbital floor reconstruction with autogenous mandibular symphyseal bone grafts", J Oral Maxillofac Surg, 55, pp.327~330 (1997)
- Mauriello JA Jr, "Use of Vicryl (polyglactin-910) mesh implant for repair of orbital floor fracture causing diplopia:a study of 28 patients over 5 years", Ophthal Plast Reconstr Surg, 9, pp.191~195 (1993)
- Burres SA, "Repair of orbital blowout fracture with Marlex mesh and Gelfilm", Layngoscope, 91, pp.1881~1886 (1981)
- Iizuka T, "Reconstruction of orbital floor with polydioxanone plate", Int J Oral Maxillofac Surg, 20, pp.83~87 (1991)
- Wellisz T, "Clinical experience with the Medpor porous polyethylene implant", Aesthetic Plast Surg, 17, pp.339~344 (1993)
- 김병진, "다공성 폴리에틸렌(Medporⓡ) 통로 삽입물을 이용한 안와골절의 치료", 대한안과학회지, 43(7), pp.20~1249 (2002), 대한안과학회
- Choi JC, "Porous polyethylene sheet implant with barrier surface: a rabbit study", Ophthal Plast Reconstr Surg, 14, pp.32~36 (1998)
- Rubin PA, "Comparison of fibrovascular ingrowth into hydroxyapatite and porous polyethylene orbital implants", Ophthal Plast Reconstr Surg, 10, pp.96~103 (1994)
- Uygur S, "Resorbable mesh plate in the treatment of blow-out fracture might cause gaze restriction", The Journal of Craniofacial Surgery, 20, pp.71~72 (2009)
- Tuncer S, "Reconstruction of traumatic orbital floor fractures with resorbable mesh plate", The Journal of Craniofacial Surgery, 18, pp.598~605 (2007)