Ulus Travma Acil Cerrahi Derg. 2008; 14(3): 247-252

Orbita tavan kýrýðýna baðlý geliþen akut travmatik ensefalosel: Porlu polietilen ile rekonstrüksiyon

Nurperi Gazioðlu, Mustafa Onur Ulu, Fatma Özlen, Mustafa Uzan, Nejat Çýplak
Ýstanbul Üniversitesi, Cerrahpaþa Týp Fakültesi, Nöroþirürji Anabilim Dalý

Bu yazýda, orbita tavan kýrýðýna baðlý bir akut travmatik orbital ensefalosel olgusunun taný ve tedavisi sunuldu. Orbita tavan kýrýðýna baðlý akut travmatik ensefalosele nadiren rastlanýr. Artmýþ intraorbital basýnç, optik sinirde geri dönüþümsüz hasara neden olabileceði için bu olgularda erken taný ve tedavi çok önemlidir. Ýnce kesitli aksiyel ve koronal orbita bilgisayarlý tomografi incelemesi, orbita travmasýnýn eþlik ettiði tüm akut travmalý hastalara uygulanmalýdýr. Bu olgularýn cerrahi tedavisinde orbita tavan kýrýðýnýn tamiri en önemli basamaktýr ve mutlaka yapýlmalýdýr. Porlu polietilen (Medpor®) birçok açýdan diðer allogreftlere üstünlüðü olan ve uzun yýllardýr rekonstrüksiyon ameliyatlarýnda kullanýlan bir materyaldir. Sunulan olguda orbita tavan rekonstrüksiyonu Medpor® kullanýlarak yapýldý, erken ve geç dönemde mükemmel sonuçlar elde edildi. Orbita tavan kýrýðý sonrasý geliþen akut travmatik ensefaloselin baþvuru tablosu, taný ve cerrahi basamaklarý hakkýndaki önemli noktalar vurgulandý.

Anahtar Kelimeler: Bilgisayarlý tomografi, Medpor; orbita tavan kýrýðý; porlu polietilen; travmatik ensefalosel.

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Acute traumatic orbital encephalocele related to orbital roof fracture: reconstruction by using porous polyethylene

Nurperi Gazioðlu, Mustafa Onur Ulu, Fatma Özlen, Mustafa Uzan, Nejat Çýplak
Istanbul University, Cerrahpasa Medical Faculty, Department of Neurosurgery

A case report of acute traumatic orbital encephalocele related to orbital roof fracture and its management were presented. Acute traumatic encephalocele related to orbital roof fracture is unusual. Early diagnosis and treatment are very important since the raised intraorbital pressure may irreversibly damage the optic nerve. Orbital computerized tomography with thin axial and coronal sections should be performed in an acute traumatized patient with a concurrent orbital trauma. Reconstruction of the orbital roof is the key step of the surgical treatment and should be performed in every case. Porous polyethylene (Medpor®) has been used for many years in reconstructive surgeries and it is superior to other allografts in many ways. In our case, the orbital roof reconstruction was done by Medpor® and the early and late cosmetic results were excellent. The important features of acute traumatic encephalocele secondary to orbital roof fractures in terms of presentation, diagnosis and surgical steps were also stressed.

Keywords: Computed tomography, Medpor; orbital roof fracture; porous polyethylene; traumatic encephalocele.

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