Orbital floor reconstruction with porus hydroxyapatite ceramics.

概要

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To treat bony defects following fracture of the orbital floor, autogenous bone or exogenous material has been used.For an autogenous bone transplant (ex. pelvic bone or rib cartilage), it is difficult to obtain an adequate volume and shape. Silicon plates are frequently used as exogenous material, but there are various complications.We are using porous hydroxyapatite ceramics (PHAC) to reconstruct orbital defects. PHAC has attracted special attention as a prosthetic inlay on account of its good biostability, biocompatibility, and bioactivity; it has been used successfully for the reconstruction of bony defects in recent years.In order to obtain a natural curve, we prepared "PHAC for the orbital floor" by measuring the orbital floor.It is a fan-shaped piece formed by dividing an empty cone (upper diameter of 20mm, lower diameter of 40mm, height 20mm, and thickness of 2mm) into three equal parts.PHAC was shaped, adapted, and perforated with a diamond bar of "Torx" intraoperatively. Then it was fixed with Nylon, screw of mini-plate, or only inserted into the bony defect.To date, we have used "PHAC for orbital floor" in 9 places in 7 patients. No changes were noted during of follow-up periods 10 to 30 months.Thus, it seems to be useful for the reconstruction of bony defects.We describe a representative case and experiments with its use.
耳鼻咽喉科臨床学会の論文