Tình trạng dung nạp mảnh ghép và kết quả liền xương sau phẫu thuật vá sàn hốc mắt bằng xương đồng loại đông khô

Abstract

Orbital floor fracture, the most common type of isolated orbital fracture, may compromise vision and cosmetic appearance, which often requires surgical repair with use of implant to support orbital tissue. Autologous bone has been considered as the most suitable material for floor reconstruction. However, the popularity has been reduced because of difficulty in harvesting graft and donor site morbidity. Various materials have been used as the substitutes but none is of favorable biocompatibility and ability of stimulating bone healing as autologous graft. In this report, we study 21 cases aged from 20 to 62 with different categories according to Jonathan classification and use lyophilized bone allograft. Patients are observed for incision healing, orbital edema at 1 week, 2 week, 1 month, 3 month and 6 month period. CT scan is taken and assessed at 6 months postoperatively. The result reveals no evidence of infection or extrusion, 95.2 % of patients demonstrating good profiles of clinical biocompatibility and one suffering from persistent orbital edema for over a month observation time that has well resolved with medical treatment. The study also evaluates CT scan imaging at 6 month time after surgery. 90.5% of cases denote well bone healing with perfect integration of bone graft into bed tissue, 2 cases (9.5%) reveal visual boundary between the graft and surrounding bone. There is no evidence of graft resorption, no difference in mean thickness of graft and newly calcified bone tissue at 6 month time postoperatively. In conclusion, the use of lyophilized bone allograft is safe for the repair of the orbital floor fracture with acceptable bone healing outcome.