鼻内镜下经鼻窦治疗眼眶爆裂性骨折临床观察

The Climcal Observation of Treating Orbit Blow-out Fracture through Nasal Sinus with Endoscope

目的探讨鼻窦内镜经鼻窦治疗眼眶爆裂性骨折的手术效果。方法对7例眶底骨折并发下直肌等软组织嵌顿,4例眶内侧壁骨折并发内直肌等软组织嵌顿,1例眶内侧壁骨折合并眶底骨折下直肌等软组织嵌入上颌窦病例,应用鼻窦内镜经上颔窦、筛窦回复窦内嵌顿或陷入的眶内软组织并用医用硅胶膜板植垫骨缺损区。结果术后经计算机体层摄影(computeoItomk-graphy.CT),12例眼眶爆裂性骨折软组织嵌顿或陷入复位完全。经患者术后随访3至18个月,平均8.2个月功能障碍性复视症状完全消失,眼位正常,未发现植垫物排斥现象,且视力均有不同程度提高。结论眼眶爆裂性骨折可应用鼻窦内镜经上颌窦、筛窦内回复固定嵌顿的眶内软组织,并具有术中眼部组织损伤小等优点。

Purpose To study the effect of treating orbit blow-out fracture through nasal sinus with endoscope. Methods For 7 cases of inferior wall fracture of orbit combining with inferior rectus musche incarcerated,4 cases of medial wall fracture of orbit combining with medial rectus muscle incarcerated,and 1 case of inferior wall and medial well fracture of orbit companying with inferior recurs musche that fell into maxillary sinus nasal sinusal endoscope through maxillary sinus and ethmoid sinusal endoscope through maxillary sinus and ethmoid sinus were ualiged we resored the soft tissues,that fell into the sinus,and tamponed bone defect with silicagel.Results 12 cases,whose orbit soft tissue fell into nasal sinus all were reduced with the examination of CT.After following-up from 3 to 18 months,the symptom of diplopia were effaced,eye position was normal,and there was no rejection about silica gel,while Their visual acuity all increased by different degress. Conclusion Treating the orbit blowout fracture,we can utlize the methods of restoring orbit soft tissues with endoscope through maxillary and ethmoid sinus,and obviously reduce the eyeball damage.