CAJ | 학술논문

目的总结发生7例鼻内窥镜术后斜视病例,探讨的手术治疗方法.方法对2010年1月至2013年8月,在北京大学第三医院眼科收治的7例患者,6例为鼻内窥镜下行鼻窦手术导致眼内直肌断裂的大角度斜视患者.另1例为下直肌损伤.患者均行眼外肌手术治疗.结果 6例患者经过直肌部分肌束转位术后斜视均改善为正位,外斜度在-5°之内;另1例失明患者,由于后部粘连严重,眼位得到部分缓解.结论眶内壁损伤导致内直肌断裂是眼部常见并发症之一.表现为外斜视、复视、眼球运动严重受限.一旦发生,需要手术矫正,手术时间应选择在内直肌断裂后3～6个月.
목적 총결발생7례비내규경술후사시병례,탐토적수술치료방법.방법 대2010년1월지2013년8월,재북경대학제삼의원안과수치적7례환자,6례위비내규경하행비두수술도치안내직기단렬적대각도사시환자.령1례위하직기손상.환자균행안외기수술치료.결과 6례환자경과직기부분기속전위술후사시균개선위정위,외사도재-5°지내;령1례실명환자,유우후부점련엄중,안위득도부분완해.결론 광내벽손상도치내직기단렬시안부상견병발증지일.표현위외사시、복시、안구운동엄중수한.일단발생,수요수술교정,수술시간응선택재내직기단렬후3～6개월.
Objective To investigate surgical management of strabismus complication following endoscopic sinus surgery.Methods A series of 7 patients with strabismus following endoscopic sinus surgery was reviewed retrospectively to characterize the type of muscle injury and report the resuits of surgical correction.Results A variety of insults to the strabismus after endoscopic sinus surgery occurred,including medial rectus muscle (MR) destructions,optic nerve rupture and inferior rectus muscle injury.High-resolution computed tomography and magnetic resonance imaging scans proved essential in determining the extent and nature of muscle injury.Surgical approaches included anterior orbitotomy with muscle recovery and transposition procedures.Conclusions If the remaining posterior segment of the MR muscle is longer than 20 mm and is contractile,muscle recovery via anterior orbital approach is suggested.If MR is destroyed,botulinum toxin A should be injected into lateral rectus muscle (LR) of the same eye to avoid 6R stiffness and fibrosis at early stage.Three months or half a year later,Hummelsheim muscle transposition or Jesen procedure can be performed.