Risk factors associated with repair of orbital and lateral skull defects.

Archives of Facial Plastic Surgery Pub Date : 2012-03-01 Epub Date: 2011-12-19 DOI:10.1001/archfacial.2011.1301
Nicholas A Serrano, Gilean N Trenité, Bevan Yueh, D Gregory Farwell, Neal D Futran, Eduardo Méndez
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引用次数: 12

Abstract

Objective: To explore the complications and associated risks factors after orbital exenteration and lateral skull base defect repair.

Methods: Patients who had undergone a reconstruction of their orbital cavity and lateral skull base defects were selected from our departmental database. The outcome of interest was postoperative complications. The risks factors were defined as age, sex, history of radiation therapy, and intracranial involvement (with and without dural involvement). Information was collected on the type of reconstruction used after the orbital cavity repair. The χ(2) test and logistic regression were used to analyze associations between postoperative complications and the various risks factors.

Results: Of the 32 identified patients, 19 had intracranial involvement (9 with dural involvement). Twenty-four patients underwent reconstruction with free tissue transfer in the same setting. Reconstruction with free tissue transfer was significantly associated with fewer major postoperative complications (P < .053). There was a trend toward more complications with a history of radiation therapy or intracranial involvement.

Conclusions: Reconstruction of the orbital cavity and lateral skull base can be challenging, especially if there is a history of radiation therapy and intracranial involvement. Free tissue transfer is a safe and effective method for reconstruction of such defects.

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眼眶及侧颅骨缺损修复的相关危险因素。
目的:探讨眶内剜除及外侧颅底缺损修复术后并发症及相关危险因素。方法:从本科数据库中选择眶腔重建及侧颅底缺损患者。关注的结果是术后并发症。危险因素定义为年龄、性别、放射治疗史和颅内受累(有无硬脑膜受累)。收集眶腔修复后使用的重建类型的信息。采用χ(2)检验和logistic回归分析术后并发症与各危险因素的相关性。结果:32例患者中,19例颅内受累(9例硬脑膜受累)。24例患者在相同的环境下进行了自由组织移植重建。游离组织移植重建与较少的主要术后并发症显著相关(P < 0.053)。有放射治疗史或颅内受累者有更多并发症的趋势。结论:眶腔和侧颅底的重建可能具有挑战性,特别是如果有放射治疗史和颅内受累。游离组织移植是修复此类缺损的一种安全有效的方法。
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