摘要
目的总结复合性眼眶骨折的治疗经验，探讨治疗中的难点问题及对策。方法回顾分析2005年1月至2010年1月中国医科大学口腔医学院口腔颌面外科诊治的89例复合性眼眶骨折患者。病例资料包括鼻．眶．筛骨折、颧-眶．上颌骨骨折、额眶骨折，其中包含复合性眼眶骨折以及创伤性眼眶骨缺损。应用冠状切口入路、经皮肤切口下睑下入路、经睑结膜切口下睑入路、眶上眉弓切口入路、上睑入路、眉间下鼻根入路、内眦内侧入路、经口腔上颌前庭沟黏膜切口入路以及小切口内镜辅助完成手术，综合应用颅颌面创伤外科、整复外科、修复重建外科、微创外科、计算机辅助和模型外科等理论和技术治疗各类型复合性眼眶骨折。对复合性眼眶骨折继发或再发眼球内陷、重度粉碎性眼眶骨折和陈旧性眼眶骨折等难点问题进行重点分析并总结疗效。结果89例患者术后眼眶外形得以恢复，眼球内陷得以纠正，通过泪道重建恢复患者泪道系统功能。其中陈旧性眼眶骨折或眼眶骨折术后畸形的发生率为38％（34／89），经治疗后畸形得到明显改善。其中6例随访时出现眼球内陷复发，经再次或多次手术效果仍不能令人满意。结论复合性眼眶骨折的治疗需要口腔颌面外科、眼科、神经外科、耳鼻咽喉科等多学科协作，达到修复畸形和改善功能的目的。重度眼球内陷的治疗、眼球内陷再发的防范和治疗、眶区严重软组织损伤和内眦畸形的治疗以及陈旧性眼眶损伤的治疗仍是目前所面临的挑战。
Objective To summarize the experiences in the treatment of complicated orbital fractures. Methods A total of 89 patients with complicated orbital fractures treated in Department of Oral and Maxillofacial Surgery, China Medical University from January 2005 to January 2010 were retrospectively reviewed. The classification of these cases included naso-orbital-ethmoid fracture, frontal orbital fracture and orbitozygomatic facture. All patients were followed up for 6-36 months. Results The orbital frame was repaired or reconstructed in these patients. The function of lacrimal pathways was improved. All the patients and the physicians were satisfied with the surgical effects. However, recurrence of deformity after endophthalmas correction was found in several cases. Conclusions The experiences, comprehensive management of complicated orbital fractures by team approaches, concluded from this study could be expanded. There are still challenges in the treatment of complicated orbital fractures, such as severe endophthalmas deformity, recurrence of endophthalmas deformity and malunion of complicated orbital fracture.
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2011年第8期458-462,共5页
Chinese Journal of Stomatology
关键词
眶骨折
修复外科手术
创伤和损伤
Orbital fractures
Reconstructive surgical procedures
Wounds and injuries
