经鼻窦内窥镜治疗眶内壁骨折合并内直肌嵌顿

Endoscopic management of medial orbital wall fracture with medial rectus insertion

目的探讨眶内壁骨折合并内直肌嵌顿的治疗方法。方法经鼻窦内窥镜治疗眶内壁骨折合并内直肌嵌顿12例(12眼),术前,术中、术后7d及术后3月以双马氏杆试验和三棱镜检查原在眼位斜视度和内转眼位斜视度。结果术后3月原在眼位斜视度比术前减少(7.83±1.70)△(q=34.84,P<0.01);内转眼位斜视度比术前减少(11.83±1.80)△,(q=42.53;P<0.01);复视和代偿头位减轻。结论以鼻窦内窥镜修复眶内壁骨折合并内直肌嵌顿,手术简便,不遗留皮肤瘢痕,对眶内组织损伤小,可迅速安全的还纳疝入筛窦的眶组织,使内直肌复位。

Objective To study the surgical management of medial orbital wall fracture with medial rectus insertion. Methods Twelve patients with medial orbital wall fracture with medial rec-tus insertion were treated with endoscopic sinus surgery. The stra- bismus angles in the primary position and the position turned to the opposite of injured eye were measured with the double Maddox rod and prism before, and after operation, Results The average stra- bismus angles decreased 7.83±1.70△（ q = 34.84, P 〈 0. 01 ） in the primary position and 11.83±1.80△（q =42. 53,P 〈0. 01 ） in the position turned to the opposite of injured eye. The compensatory head postures were eliminated and diplopia was reduced after opera- tion, Conclusions It is a simple and convenient method for re- pairing the medial orbital wall fracture with medial rectus insertion with endoscopic sinus surgery. The inserted muscle and orbital con- tents can be restored safely and rapidly . There is no scar to be left on the face postoperatively.