RESUMEN
OBJECTIVE: To explore the clinical efficacy of endoscopic repairing pediatric blowout fracture of orbital floor with autologous bone fragment. METHODS: A total of 12 cases with blowout fractures of orbital floor between March 2010 and June 2012 at Third Hospital of HeBei Medical University were reviewed. They underwent nasal endoscopic reconstruction of autologous bone fragment in situ. Medicinal biomaterial glue was used for fixation. A 6-month follow-up was performed and the therapeutic efficacies of anatomic and functional recovery were evaluated. RESULTS: No further vision loss or infection occurred postoperatively. Diplopia disappeared over a period of 3 days to 6 months. At 3 months post-operation, diplopia vanished completely (n = 9), and peripheral vision diplopia persisted (n = 3). Only 1 case had still peripheral vision diplopia at 6 months. Enophthalmos: ≥ 2 mm (n = 1), 1 mm (n = 3) for one week after surgery and only 1 mm (n = 1) at one month follow-up. Passive traction test was negative in all cases and computed tomograph (CT) revealed no bone redislocation postoperatively. CONCLUSION: Endoscopic repair of pediatric blowout fracture of orbital floor with autologous bone fragment in situ is both effective and safe.
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Trasplante Óseo/métodos , Endoscopía/métodos , Órbita/lesiones , Fracturas Orbitales/cirugía , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Cavidad Nasal/cirugía , Estudios Retrospectivos , Trasplante AutólogoRESUMEN
OBJECTIVE: To explore a minimally invasive technique with hydroxylapatite artificial bone to repair the orbital blowout fracture. METHODS: Twenty-one cases of orbital blowout fracture from March 2008 to April 2010 were enrolled. And the fractures were repaired with a bridge of hydroxylapatite artificial bone under a nasal endoscope. During a regular 6-month follow-up, anatomic and functional recovery was evaluated. RESULTS: There was neither postoperative visual loss nor infection in all cases. At 3 months post-operation, diplopia vanished completely (n = 17), remained in peripheral vision (n = 2), existed in primary ocular position (n = 2) and the deviation of eyeball (n = 1). At Month 3, diplopia in peripheral vision or in primary position and the deviation of eyeball showed no improvement. Compared with the uninjured side, enophthalmos: ≤ 2 mm (n = 18), > 2 mm (n = 2) and > 4 mm (n = 1). The passive traction test was positive in one case. On computed tomograph (CT) scanning, there was no bone dislocation or slippage in all cases. CONCLUSION: The surgical efficacy is excellent. The technique of combining the advantages of endoscopic sinus approach and hydroxyapatite artificial bone is worth a wider popularization.
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Sustitutos de Huesos/uso terapéutico , Durapatita/uso terapéutico , Cavidad Nasal/cirugía , Fracturas Orbitales/cirugía , Adolescente , Adulto , Endoscopía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Adulto JovenRESUMEN
BACKGROUND: Mesenchymal stem cells can be isolated from various tissues besides bone marrow and can differentiate into cells of three germ layers. Recent studies indicate that some cells in corneal stroma express stem cell markers and can also differentiate into chondrocytes and neurocytes. This study was carried out to investigate whether mesenchymal stem cells reside in the murine corneal stroma. METHODS: Corneas of BALB/c mice were treated with collagenase digestion after the epithelium and endothelium were removed. Then the single cells were harvested and further identified by reverse transcription polymerase chain reaction (RT-PCR). After the immunophenotype of passage 2 corneal stroma-derived cells was analyzed by flow cytometry, attempts were made to differentiate these cells into adipocytes and osteocytes using conditioned medium. Following induction, cells were evaluated by RT-PCR, oil red O and Alizarin Red staining. RESULTS: Isolated single cells were of stromal origin, not of epithelial or endothelial. Passage 2 corneal stroma-derived cells exhibited the spindle-shaped morphology and expressed CD29, CD90, CD105, and CD71; but were negative for CD34 and CD45. In addition, these cells showed the potentiality of differentiating into adipocytes and osteocytes, which was confirmed by RT-PCR and staining. CONCLUSION: This study demonstrates the presence of mesenchymal stem cell-like cells in the murine corneal stroma. Further analysis of these cells will aid elucidation of the mechanisms of some keratopathies, and these cells may be a source for bioengineering of corneal tissue and for cell-based therapeutics.