COMPARATIVE CHARACTERISTICS OF AUTOTRANSPLANTS FOR THE TREATMENT OF ORBITAL DAMAGES

The article is devoted to the study of biomechanical and physiological characteristics of autografts of bone and cartilage origin. Such parameters as the degree of resorption of the autograft, the ease of its lifting, mobilization and harvesting, the probability, frequency and nature of postoperative complications were studied. Currently, there are many materials for the reconstruction of this topographic-anatomical area, each of which has its advantages and disadvantages, both in its traumatic defects and in orbitopathy. Discussions continue regarding the most optimal method of surgical treatment based on the estimated characteristics of the frequency and nature of complications in the immediate and distant postoperative period. Today, the literature contains contradictory data on the comparative characteristics and choice of materials for orbital reconstruction, their advantages and disadvantages, which determined the chosen direction of research. Donor sites include split skull bone graft, rib, maxillary wall, mandibular symphysis, iliac crest, antrum, and coronoid process. In a retrospective case history review, it is noted that they can be used as overlay grafts (15%), fixed with a plate and screw (22%), fixed with a delayed screw, or fixed in combination with an alloplastic material such as titanium mesh (63%). Another commonly used source of autograft for orbital reconstruction is cartilage. According to our clinic, autografts with inclusion of the quadrilateral nasal cartilage are most commonly used in 52% of cases, costal cartilage in 31%, and auricular cartilage in 17%. When using autocartilage tissue, according to our data, the number of complications is reduced by an average of 1719% compared to alloplastic bone materials. Thus, the use of autografts requires a high qualification of the surgeon in its lifting and mobilization, which creates a forced empiricism in the algorithm of surgical interventions. It has been established that in traumatic injuries in 87% of cases, bone autografts should be used, and the feasibility of using cartilage in the diagnosis of orbitopathy is 57-62%. It has been proven that the lifting and mobilization of autografts of both bone and cartilage origin are associated with certain limitations in the area of the donor site with a limited number of their removal.