가토의 안와 하벽골절 재건 시 삽입물에 따른 초기 섬유혈관화 양상 비교 : 비흡수성 다공성 폴리에틸렌 삽입물 (Medpor) vs 흡수성 코폴리머 삽입물 (Macropore)

다국어 초록 (Multilingual Abstract)

Although the reports of successful treatment results of orbital fracture are numerous, histopathologic changes of this favorable outcome have not yet to be established. The purpose of this study is to observe the fibrovascular tissue between the implant and orbital connective tissue and fibrovascular ingrowth into the implant in orbital floor fracture of animal model.
Twenty four New Zealand white rabbits were used. A standardized 6-mm diameter sized defect was made bilaterally in the maxillary sinuses to include bone and mucosa and 8 x 8 mm size alloplastic implant was inserted. As a control group, bone defect was made but alloplastic implant was not inserted. Two different implant materials with 1 mm width were used: porous high-density polyethylene which has solid polyethylene lining (barrier surface) of 0.2 mm width (Medpor？？, Group A) and absorbable copolymer (Macropore？？, Group B). The implants were harvested at 1-, 2- and 6- week after implantation. H&E stains and immunohistochemical study on basic fibroblast growth factor (bFGF) and CD-31 (Platelet endothelial cell adhesion molecule, PECAM-1) were conducted.
Full thickness fibrovascular ingrowth into the implant was observed in group A after two weeks, but there was no fibrovascular ingrowth into the implant in group B. Inflammatory reaction between the implant and the connective tissue was grade 2 at 1 week and grade 1 at 2 and 6 weeks in both groups. The bFGF index in fibrovascular tissue which grew into the non-absorbable porous polyethylene implant (Group A-1) was 0.3 at 1 week, 2.3 at 2 weeks and 3.0 at 6 weeks. The bFGF index at the surface tissue on the implant in non-absorbable porous polyethylene implant (Medpor？？, Group A-2) and Group B were 1.0 and 1.8 at 1 week, 2.5 and 2.8 at 2 weeks, 3.0 and 3.0 at 6 weeks. Expression of CD31 in Group A-1 was 3.8 at 1 week, 6.0 at 2 week, 20.3 at 6 weeks. Expression of CD31 in Group A-2 and Group B were 19.8 and 23.3 at 1 week, 38.0 and 49.3 at 2 weeks, 64.3 and 72.0 at 6 weeks.
Because absorbable copolymer implant showed no fibrovascular ingrowth into the implant, it may have an advantage in orbital wall fracture with exposure of extraocular muscle. On the contrary, the possibility of migration and dislocation of the implant cannot be excluded in absorbable copolymer implant because there was no fibrovascular ingrowth into the implant. Therefore, non-absorbable porous polyethylene implant has an advantage in orbital wall fracture which is worried about implant migration and dislocation in the early postoperative period and large orbital wall fracture.

목차 (Table of Contents)

• 목 차
• Abstract •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• i
• I.서론 ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 1
• II.실험대상 및 방법 ••••••••••••••••••••••••••••••••••••••••••••••• 3
• III.결 과 ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 5
• IV.고 찰 ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 6
• V.결 론 ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 9
• VI.참고문헌 •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 10