鼻内镜下眼眶爆裂性骨折的修复

目的观察鼻内镜协助下经结膜切口以Medpor材料修复眶下壁骨折效果。方法单纯爆裂性眶下壁骨折13例，采用结膜切口联合外眦皮肤切开入路，鼻内镜下取出游离的碎骨片，将嵌顿的下直肌及其他眶组织充分游离还纳至眶内，植入修剪塑形后的Medpor板重建眶下壁，随访4～12个月，观察眼位、复视、眼球内陷及眼球运动改善情况。结果术后所有患者复视及眼球运动受限均得到不同程度的改善。10例复视完全消失，眼球运动恢复正常；3例好转（其中2例伤后近2个月手术）。眼球内陷均在1mm以内。结论鼻内镜下经结膜切口眼眶爆裂性骨折整复术合并Medpor板植入可有效矫正眼球内陷及复视，效果良好，并发症少。

Repair of orbital blowout fracture under nasal endoscopy

Objective To observe the treating effect of orbital reconstruction in transconjunctival approach with Medpor implants under nasal endoscopy. Methods Thirteen patients with simple orbital floor blowout fracture were treated in transconjunctival approach combined with skin incision under endoscopy. Under the nasal endoscopy, the entrapped orbital tissue was completely reduced and the orbital floor fracturewas repaired with Medpor implants. All patients were followed up for 4 - 12 months postoperatively. The changes of diplopia, eye position and eye movement were observed. Results All patients showed improve- ment of their symptoms. Disappeared diplopia and normal eye movement were in 10 patients. Three patients showed persistent diplopia （ operations were done nearly 2 months after trauma in 2 cases）. The depth of the endophthalmos in all patients was within 1 mm. Conclusion The reconstruction of simple orbital floor blowout fracture with Medpor implants in transconjunctival approach under nasal endoscopy has an excellent clinical effect and fewer complications to correct endophthalmos and diplopia.