Effectiveness and safety comparison of three eye and orbital reconstruction techniques in facial plastic surgery.
Ann Chir Plast Esthet
; 64(4): 351-361, 2019 Aug.
Article
en En
| MEDLINE
| ID: mdl-30792013
ABSTRACT
PURPOSE:
To compare the effectiveness and the safety of three eye reconstruction techniques with porous bioceramic implantation in facial surgery the "four petals" eye evisceration (EE) technique, the "russian doll" EE technique and the enucleation with "on-the-table" evisceration technique.METHODS:
Retrospective review of patients who underwent surgical orbit reconstruction with primary placement of a porous bioceramic orbital implant using three techniques at Quinze-Vingts National Center (Paris, France). We compared outcomes of three surgical orbit reconstruction techniques the "four petal" EE technique, the "russian doll" EE technique and the enucleation with "on-the-table" evisceration technique. The primary endpoint was to determine the rate of implant exposure and the facial cosmetic result during the first year after surgery for each technique. The mean of the Numeric Pain Rating Scale (NRS) after surgery at day 1 was also a primary endpoint. In addition, data such as analgesic intake and rate of revision surgery were compared for each technique.RESULTS:
One hundred and ten patients were included 70 patients in the "four petals" procedure group, 31 in the "on-the-table" procedure group and 9 in the "russian doll" procedure group. NRS pain at day 1 was statistically significantly lower in the "four petals" procedure group 0.9 [standard deviation (SD)] (1.8) and in the "russian doll" procedure group 1 (1.7) than in the "on-the-table" procedure group 2.5 (2.4) (P=0.001). Implant exposure was statistically significantly lower in the "four petals" procedure group (2.9%) and in the "on-the-table" procedure group (3.2%) when compared to the "russian doll" procedure group (22.2%) (P=0.03). Rate of revision surgery was lower in the "four petals" procedure group (11.5%) than in the "russian doll" procedure group (33.3%) and the "on-the-table" procedure group (22.6%). "russian doll" evisceration procedure group had the highest orbital lipofilling rate due to the highest rate of enophthalmos. Therefore, the cosmetic result was better in the "four petals" and the "on-the-table" procedure group.CONCLUSION:
The "four petals" EE technique for surgical eye and orbital reconstruction seems to be a method that reduce implant extrusion, postoperative pain and improve facial esthetic result.Palabras clave
Chirurgie plastique du visage; Déformation du visage; Facial deformity; Facial plastic surgery; Implant extrusion rate; Numeric Pain Rating Scale (NRS); Surgical eye and orbital reconstruction technique; Taux d'extrusion d'implant orbitaire; Technique de reconstruction chirurgicale oculaire et orbitaire; Échelle numérique (EN) de la douleur
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Órbita
/
Procedimientos Quirúrgicos Oftalmológicos
/
Evisceración del Ojo
/
Implantación de Prótesis
/
Procedimientos de Cirugía Plástica
/
Ojo Artificial
Tipo de estudio:
Observational_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Ann Chir Plast Esthet
Año:
2019
Tipo del documento:
Article