颅面骨复合骨折的诊治

The treatment of skull compound fracture

目的 探讨颅面骨复合骨折的治疗方法。方法 对 38例不同部位颅面骨复合骨折病例 ,19例行鼻内窥镜手术治疗 ,5例行额部冠状切口加上唇面揭式切口复位 ,14例行柯陆式进路加鼻窦内窥镜联合复位。结果12例恢复正常鼻眼功能 ;11例上睑下垂改善 ,睑裂增宽 ;7例视力未恢复 ;8例遗留面部畸形。结论 CT是诊断颅面骨复合骨折最精确的方法 ,对术式的选择也有重要临床价值。对较严重的眶纸板并发其它部位的复合骨折 ,行鼻内窥镜下手术疗效满意 ;颅面多发而复杂的骨折采用额顶部冠状切口加面揭式切口联合复位术野暴露好 ,直视下手术 ,可准确查明骨折部位和施行正确的复位固定 ,不留面部疤痕 。

Objective To investigate the treatment of skull compound fracture.Methods Diffenrent treatment were taken on 38 cases with skull compound fracture of different position.25 cases were treatment in endoscope, 5 cases were reduced by coronal incision in ferehead and incision of uncovered face in upper lip,8 cases were reduced by endoscope and ke-lu approach.Result Normal fonction of nose and eye were recovred on 12 cases, 11 cases ptosis were improved , 7 cases vision hav't recovered,8 cases leaved over deformity in face.Conclusion CT is accurate methord for diagnosing skull compund fracture. CT diagnosis have a significant clinical value for selecting operational fashion.Opratical effect of sinuses endoscope of grave striking fracture of ethmoid was satisfied. The reposition of skull compound fracture by crowned incision in forehead and incision of open face was satisfied. To operate in audiovisual, the position of fracture can prove and was fixed exact. The methord of operation without scar formation in the face. [