影像学检查指导下的眼眶手术入路选择

目的:探讨影像学检查指导下的眼眶手术常用入路的适应证及手术技巧.方法:对2000～2004年长征医院眼科收治的常见眼眶病495例的B型超声、CT、MRI影像学表现及手术方式和手术径路进行回顾性分析.结果:根据眼眶病变在影像学检查中常见的发生部位及形态特征、继发性改变等,正确作出定位、定性诊断,并进一步选择手术方式及径路,495例各种眼眶手术,其中行前路开眶术239例,外侧开眶术243例,内侧开眶术9例,眶内容切除术4例.结论:在影像学检查的提示下,眼眶手术入路的选择要根据病变的性质、范围、位置等多种因素共同决定,应尽可能选择术野广、损伤小、外观好的手术入路.

Surgical approach selection for various orbital diseases under guidance of image examination

Objective: To study the indications and operative skills of common surgical approaches for orbitotomy under the guidance of imaging examination. Methods: We retrospectively analyzed the B-ultrasound, CT and MRI results and surgical procedures of 495 patients with common orbital diseases, who were adopted to Changzheng Hospital during 2000-2004. Results: The location, shape, and secondary changes of the orbital diseases detected by imaging examination provided references for making correct diagnosis and selecting suitable surgical procedures. Patients were divided into 4 groups according to the surgical procedures they received: anterior orbitotomy (n=239), medial orbitotomy (n=9), lateral orbitotomy (n=243) and exenterations (n=4). Conclusion: With the guidance of imaging examination, surgical procedures for orbital diseases should be selected in consideration of pathological characteristics, involvement and location of the lesions. Surgical approaches with a broad operation field, small incision and better appearance should be chosen.