摘要
目的 探讨鼻眶筛骨折的手术入路、骨折复位与坚固内固定及合并眼球内陷的处理方法。方法 对 17例鼻眶筛骨折患者进行回顾性研究 ,根据CT结果与Fedor骨折分型分为三型 ,其中Ⅰ型 1例 ,Ⅱ型 7例 ,Ⅲ型 9例 ;13例选用鼻根正中入路 ,3例鼻旁入路 ,7例需同时附加眶下切口。 8例合并眼球内陷者采用眼球赤道后方碘仿纱条填塞与植骨矫正法。结果 ①本组病例平均内眦宽度和内眦宽度 /外眦宽度比例从 ( 35± 7)mm、( 37± 8) %恢复到 ( 32± 4 )mm、( 35± 7) %比较正常水平 ;②面部外形全部恢复到正常或接近正常 ;③ 8例眼球内陷患者术后 6例恢复到基本正常 ,2例术后仍有轻度凹陷 ,5例复视术后全部消失。结论 鼻根正中入路附加眶下切口可充分显露骨折片 ,结合坚固内固定技术可使骨折片解剖复位 ;内眦韧带复位固定是本手术关键所在 ,重建正常眶内容积和眶内容物准确复位 。
Objective To investigate the surgical entrance, fractural reduction and rigid fixation of naso orbital ethmoid fractures as well as therapy of them compounded with eyeball invagination . Methods All 17 patients with naso orbital ethmoid fractures were reviewed retrospectively . All the patients were grouped by results of CT and Foder's classification . The patients were grouped as follows : typeⅠ1 ,typeⅡ7 and type Ⅲ 9 patients . Thirteen patients were operated with central naso root entrance and 3 with nasal lateral approach . In addition , inferior orbital incision was also needed for 7 patients. Eight patients with enophthalmos were given stuffing with ribbon gauze and grafting bone into posterior eyeball equator. Results ① Averaged innercanthal width and the ratio of inner and outercanthal widths of patients were from (35±7) mm and (37±8)% to (32±4)mm and (35±7)% , respectively . ② Facial appearance of all of the patients was restored to the normal or nearly normal .③Six of 8 patients with enophthalmos were restored to the normal .Others were approved with slightly depression. Diplopia of 5 patients disappeared after operation . Conclusion Nasal median entrance accompanied by inferior orbital incision can expose fractural fragments sufficiently,which can receive anatomic reduction combined with rigid fixation . Precise attachment of intercanthal ligament is critical to the operation . Reconstruction of normal orbital capacity and reduction of orbital contents are of benefit to enophthalmos and obstruction of eyeball movement .
出处
《山西医科大学学报》
CAS
2003年第6期569-571,共3页
Journal of Shanxi Medical University
基金
山西省科技厅科技攻关项目
关键词
鼻眶筛骨折
治疗
临床评价
外科手术
nasal bone
fracture
orbital fractures
treatment outcome
