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Objective To summarize the effect of eye socket reconstruction in patients with severe depressed eye socket combined anophthalmos and to assess the methods of eye socket reconstruction.Methods Forty patients of severe depressed eye socket combined anophthahnos,from Oct,2001 to Mar,2014,underwent eye socket reconstruction in Beijing Tongren Hospital.Thirty four eye sockets were reconstructed with free flap,the scapular flap in 2 cases,the forearm flap in 17 cases,the lateral arm flap in 15 cases.The reversed submental island flap was utilized in 2 patients.The other 4 cases were treated by implant-retained orbital prosthesis.Results All the patients were followed up for more than 2 years.The flaps survived.The artificial eye could be fitted satisfactorily and the appearance of the ill eye socket was improved significantly.The implant-bodies in orbital bone and the prosthesis were stable without peri-implantitis.Conclusions The flap transfer is effective for eye socket reconstruction in patient with severe depressed eye socket combined anophthalmos.The implant-retained orbital prosthesis is also alternative.The treatment choice must be based on the patient 's own conditions.
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Objective To investigate the clinical outcome of correction of unilateral delayed orbitozygomatic complex fractures with digital guide plates.Methods The study involved 14 cases of unilateral delayed orbitozygomatic complex fractures treated between September 2007 and March 2012.Craniofacial structures were measured by thin-section CT before operation,followed by data input to the image processing software.Before and after the processing of images,three dimensional skull models were produced using rapid prototyping technique and applied to have surgical simulation.Digital guild plates were produced for guiding the reduction of fractures and orbital walls were reconstructed as well.Results All cases were followed up for a period of 6-11 months,which showed basic restoration of facial structure and significant correction of diplopia and enophthalmos,with no infection or dislocation of implants buried in orbit floor.Mild ectropion of the lower eyelid occurred in one case and temporary decrease of frontal wrinkle in two cases,but all recovered in 3-6 months postoperatively.Conclusion Digital guide plate is easy in operation and reliable for treatment of unilateral delayed orbitozygomatic complex fractures.
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Objective To explore the method of target volume determination of postoperative 125I seeds interstitial brachytherapy in parotid gland carcinoma.Methods A total of 31 cases( 14 males and 17 famales) with primary parotid carcinoma who were treated in Peking University Hospital of Stomatology from Oct 2002 to Nov 2006.The patients' average age was 38.2 years.All patients underwent tumor resection and postoperative 125I seeds interstitial brachytherapy with 60 Gy matched peripheral dose.The spiral CT was performed for treatment plan and quality verification before and after the brachytherapy.The bone and muscle landmarks surrounding parotid were selected as reference for target volume determination.D90 of target volume and dose of organs at risk were calculated,while the target volume and D90 of target volume of verification were compared with that of treatment plan through quality verification.Results The target volume or D90 of target volume before and after treatment was not statistically different.D90 of target volume was more than 60 Gy.During 3 -7 years of follow-up,all patients had no recurrence.ConclusionsAccording to the follow-up results,the method used for target volume determination in this paper might be satisfied.
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Objective To study the influence of 125I seed interstitial brachytherapy in parotid region on the recovery of facial nerve function. Methods A total of the data of 21 patients with primary parotid carcinoma were treated with resection and 125I interstitial brachytherapy. All the patients had no facial palsy before operation and the prescribed dose was 60 Gy. During 4 years of follow-up, the HouseBrackmann grading scales and ENoG were used to evaluate the function of facial nerve. According to the modified regional House-Brackmann grading scales, the facial nerve branches of patients in affected side were divided into normal and abnormal groups, and were compared with those in contra-lateral side.Results Post-operation facial palsy occurred in all the patients, but the facial palsy recovered within 6 months. The latency time differences between affected side and contralateral side were statistically significant in abnormal group from 1 week to 6 months after treatment ( t = 2.362, P = 0.028 ), and were also different in normal group 1 week after treatment ( t = 2.522, P = 0.027 ). Conclusions 125I interstitial brachytherapy has no influence on recovery of facial nerve function after tumor resection and no delayed facial nerve damage.
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Objective To observe the fixity of 125I seed after implantation in parotid region. Methods Ten patients treated with 125I seed interstitial brachytherapy in parotid were randomly selected. Within one week after the treatment, two plane radiographs were taken by radiotherapy simulator and 125I seed was counted. All plane dosimetry analysis were performed by treatment planning system. The areas surrounded by 50%, 100% and 150% of prescription dose curve and dose equality index were calculated. Two months after the treatment, the same examination were repeated and were compared with t test. Results The number of seeds was equal in two examination. There were no signifieant differences in two examinations either for the areas surrounded by 50%, 100% and 150% of prescription dose curve or for the dose equality index. Conclusions The position of 125I seed after implantation in parotid region is quite fixable, which can ensure the curative effect.