中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
Chinese Journal of ocular trauma and occupational eye disease
2015年
9期
689-691
,共3页
荆文涛%王瑞峰%刘建君%唐文建%吴文灿
荊文濤%王瑞峰%劉建君%唐文建%吳文燦
형문도%왕서봉%류건군%당문건%오문찬
眶骨折,眶尖内壁%修复%内窥镜
眶骨摺,眶尖內壁%脩複%內窺鏡
광골절,광첨내벽%수복%내규경
Orbital fractures,medial wall,near the apex%Repair%Endoscopy
目的 探讨内窥镜在近眶尖部的眶内壁骨折修复中的应用价值.方法 近眶尖部的巨大眶内壁骨折40例,均经泪阜径路在鼻内窥镜下进行骨折修复.眶壁骨折范围在术中进行测量,以多孔聚乙烯板修补骨壁缺损.术后随访6 ～15个月.结果 所有手术均顺利完成.在内窥镜直视下,所有嵌顿和疝出的眶内容均被松解和复位,骨折边界均被充分暴露,植入物均完全覆盖所有骨折边界.术后6个月,骨折缺损的解剖复位通过CT证实,双眼突出度对称者39例,占全组40例的97.50％,平均矫正(3.37±0.77)mm.原跟位30°复视的18例中16例得到矫正(88.89％).2例(11.11％)向鼻侧注视时残余复视,分析可能为内直肌麻痹.1例术后ld眶内出血,保守治疗后恢复.结论 内窥镜下经泪阜修复眶尖附近的巨大眼眶内壁骨折,可以清楚显示骨折的边缘尤其是后缘,确保将补片精确覆盖在骨折边缘达到解剖复位,并发症少.
目的 探討內窺鏡在近眶尖部的眶內壁骨摺脩複中的應用價值.方法 近眶尖部的巨大眶內壁骨摺40例,均經淚阜徑路在鼻內窺鏡下進行骨摺脩複.眶壁骨摺範圍在術中進行測量,以多孔聚乙烯闆脩補骨壁缺損.術後隨訪6 ～15箇月.結果 所有手術均順利完成.在內窺鏡直視下,所有嵌頓和疝齣的眶內容均被鬆解和複位,骨摺邊界均被充分暴露,植入物均完全覆蓋所有骨摺邊界.術後6箇月,骨摺缺損的解剖複位通過CT證實,雙眼突齣度對稱者39例,佔全組40例的97.50％,平均矯正(3.37±0.77)mm.原跟位30°複視的18例中16例得到矯正(88.89％).2例(11.11％)嚮鼻側註視時殘餘複視,分析可能為內直肌痳痺.1例術後ld眶內齣血,保守治療後恢複.結論 內窺鏡下經淚阜脩複眶尖附近的巨大眼眶內壁骨摺,可以清楚顯示骨摺的邊緣尤其是後緣,確保將補片精確覆蓋在骨摺邊緣達到解剖複位,併髮癥少.
목적 탐토내규경재근광첨부적광내벽골절수복중적응용개치.방법 근광첨부적거대광내벽골절40례,균경루부경로재비내규경하진행골절수복.광벽골절범위재술중진행측량,이다공취을희판수보골벽결손.술후수방6 ～15개월.결과 소유수술균순리완성.재내규경직시하,소유감돈화산출적광내용균피송해화복위,골절변계균피충분폭로,식입물균완전복개소유골절변계.술후6개월,골절결손적해부복위통과CT증실,쌍안돌출도대칭자39례,점전조40례적97.50％,평균교정(3.37±0.77)mm.원근위30°복시적18례중16례득도교정(88.89％).2례(11.11％)향비측주시시잔여복시,분석가능위내직기마비.1례술후ld광내출혈,보수치료후회복.결론 내규경하경루부수복광첨부근적거대안광내벽골절,가이청초현시골절적변연우기시후연,학보장보편정학복개재골절변연체도해부복위,병발증소.
Objective To investigate the appilication value of endoscopy for repairing of large medial orbital wall fractures (MOWFs) near the orbital apex.Methods Forty patients with large MOWFs near the orbital apex underwent fracture repair under endoscopy through lacrimal caruncle pathway,and the range of the fracture was measured during the surgery.Porous polyethylene sheet was used to repair the bony defects.Patients were followed up for 6 to 15 months.Results All surgeries were completed successfully.Under direct endoscopic visualization,all entrapped and herniated orbital contents were released and reset,the entire boundary of the fractures were exposed adequately,and the implants were placed to cover all edges of the fracture in all cases.The ranges of vertical and horizontal fracture defects measured during the surgeries were 16-30 mm and 25-34 mm respectively.Six months after the surgery,anatomical reduction of the bony defects was confirmed by orbital CT scans,and symmetry of the protopsis in both eyes was acquired in 39 of 40 patients (97.50％),with a mean correction of (3.37 ± 0.77) mm.Diplopia within 30° visual field of the gaze was resolved in 16 of 18 patients (88.89％).Two patients (11.11％) had residual diplopia on medial gaze because of presumed paralysis of the medial rectus muscle.Intraorbital hemorrhage occurred in 1 patient at the first day after the surgery and resolved with conservative treatment.Conclusion The transcaruncular endoscopy reparing seems to be a useful method for recovery of the normal anatomic features of the orbits in patients with large MOWFs near the orbital apex.
