眼眶爆裂性骨折患者的手术疗效分析

目的 探讨眼眶爆裂性骨折患者的手术治疗效果。方法 回顾性总结1994－1999年经不同入路开眶术治疗56例眼眶爆裂性骨折患者的手术疗效。结果 结膜或下睑睫毛下皮肤入路开眶术52例,眉弓皮肤入路2例,结膜－口腔联合入路开眶术2例,术前平均眼球内陷3.4mm,术后平均内陷1.2mm,术后复视症状完全消失18例,部分消失25例,无变化9例。术后出现眶下神经麻痹4例,置入硅胶移位1例。结论 手术是治疗眼眶爆裂性骨折的较好方法,手术疗效与手术时机及填充物体积相关,经结或下睑睫毛下皮肤入路开眶术具有操作简单,暴露充分,术后无可见瘢;术中充分松解嵌顿的眼外肌防止再粘连是消除复视的关键。

Surgical treatment of orbital blow-out fracture

Objective To evaluate the effect of surgical treatment for blow out fractures. Methods Fifty six cases with blow out fracture treated by surgery from 1994 to 1999 were reviewed and summarized, and their surgical effects were analyzed. Results The surgical approaches were as follows: anterior orbitotomy in 52 cases, through brow in 2 cases, anterior orbital with oral approach in 2 cases. The enophthalmos was from the mean of 3 4 mm to 1 2 mm after operation. The diplopia completely disappeared in 18 cases and partly disappeared in 25 cases after operation. Diplopia was still presented in 9 cases post operatively. There were 4 cases with inferior orbital nerve anesthesia after operation. Conclusions Surgical management is an effective means of blow out fractures. The effect is related to the time selected for surgery. Transconjunctival approach has advantages of easy operation, full exposure and invisible scar. This is the key method to eliminate diplopia since it may fully loose the incarcerated muscle and reduce secondary adhesion.