Frontobasal and orbital reconstruction following trauma and tumor removal using a compound of bone meal, antibiotic, and fibrin sealant.
In the treatment of fronto-basal cerebrocranial trauma and primary or secondary orbital tumors, definitive surgical intervention in one sitting has proven very successful. The orbital roof, the lateral orbital walls, and the frontal base are reconstructed with a bone meal/fibrin sealant plastic, whereas the orbital rims are revised using available bone fragments refitted using osteosynthetic procedures. Remaining calotte defects are covered alloplastically with Refobacin-Palacos. Bones can be easily remodeled with the bone meal/fibrin sealant plastic. The fibrin sealant holds the shape in regions not subject to mechanical stress, and contributes to an immediate, watertight closure. The addition of an antibiotic achieves effective prophylaxis against infections in the initial phase. The result is an autologous bone which provides a maximum of protection against late infections such as occur in alloplasties and against ascending infections with meningitis, as observed in unreconstructed bone defects. Since the bone meal is usually obtained during trepanation, bone biopsies of other body regions are unnecessary.
Knöringer
P
P
Department of Neurosurgery, University of Ulm, Günzburg, West Germany.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D007611:Aprotinin / Q000627:therapeutic use; D001688:Biological Products; D001930:Brain Injuries / Q000628:therapy; D006259:Craniocerebral Trauma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D004338:Drug Combinations / Q000627:therapeutic use; D005176:Factor XIII / Q000627:therapeutic use; D015718:Fibrin Tissue Adhesive; D005340:Fibrinogen / Q000627:therapeutic use; D006801:Humans; D008903:Minerals / Q000627:therapeutic use; D009915:Orbit / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D009918:Orbital Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011859:Radiography; D013917:Thrombin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D001688:Biological Products; D004338:Drug Combinations; D015718:Fibrin Tissue Adhesive; D008903:Minerals; D005340:Fibrinogen; D005176:Factor XIII; D007611:Aprotinin; D013917:Thrombin; C027762:bone meal