眶平衡减压术相关解剖及临床应用的研究

Clinical application of balanced orbital decompression and applied anatomy of lateral wall of orbit

目的通过眶外侧壁应用解剖研究,探讨眶平衡减压手术的方法及疗效。方法对10具头颅骨眶外侧壁解剖观察及相关数据测量,临床应用眶平衡减压术治疗甲状腺相关眼病共3眼。结果涉及眶平衡减压术的眶外侧壁相关骨性结构有颧额缝、颧额蝶交点、眶下裂等结构,颧额蝶交点至眶下裂距离(外侧面)为(22.4±2.6)mm、眶缘至颧额蝶交点距离(眶面)为(15.6±4.0)mm、颧额缝至眶下缘距离为(22.2±3.4)mm。眶平衡减压术3眼,术后眼球回缩平均为6 mm,无术后并发症发生。结论掌握眶外侧壁解剖,眶平衡减压术手术安全、疗效确切。

Objective To study the applied anatomy of lateral wall of orbit relevant to the balanced orbital decompression and investigate the technique of this operation. Methods The structures of lateral wall of orbit were observed in 10 skulls. The balanced orbital decompression was performed in 3 eyes in patients with thyroid-associated ophthalmopathy. Results The anatomic marks, such as the zygomaticofrontale sutura, the zygomaticotemporal sutura, the zygomaticofrontotemporal point and fissure orbital inferior, were relevant with the balanced orbital decompression. The distance between zygomaticofrontotemporal point and fissure orbital inferior in fossa temporalis side was （22.4±2.6） mm. The distance between the brim of orbit and zygomaticofrontotemporal point in orbital side was （15.6 ± 4.0） mm. The distance between zygomaticofrontale sutura and inferior brim of orbit was （22.2 ± 3.4） mm. Exophthalmos improved approximately by a mean of 6.0 mm and no complications occurred in 3 eyes after surgery. Conclusion The balanced orbital decompression is an effective method for thyroid-associated ophthalmopathy. Wellunderstanding the anatomy of lateral wall of orbit is essential for the safety of this surgical technique.