早期手术治疗外伤性鼻额眶筛复合性骨折

Early Stage Surgical Repair for Traumatic Complex Nasal-frontal and Orbital-ethmoid Fracture

目的:探讨外伤性鼻额眶筛复合性骨折的早期手术治疗的经验和效果。方法:2001.7～2006.1收治的6例外伤性鼻额眶筛复合性骨折的患者,早期经双冠状切口进路清除坏死组织和游离碎骨片,矫正鼻额眶筛畸形,其中同时修复颅底以修补脑脊液漏2例,联合犬齿窝入路上颌骨复位术和鼻内镜经鼻进行视神经眶内段减压术行视神经管减压各1例。结果:6例患者术后颅面外观满意,随访22个月～5年,未见面容畸形和瘢痕挛缩。有1例术后1月出现CSF鼻漏,经保守治疗1月后治愈,随访3年无复发。结论:早期手术治疗外伤性鼻额眶筛复合性骨折有利于鼻额眶畸形整复、颅神经功能恢复和防止脑脊液漏引起的颅内感染。

Objective： To explore clinical experiences and effects of early stage surgery on traumatic complex nasalfrontal and orbital-ethmoid fracture. Methods： From June 2001 to January 2006, There are six traumatic complex nasalfrontal and orbital-ethmoid fracture patients accepted the Double-coronary incision approach to remove necrotic tissue, dissociative sclerite and correct the nasal-frontal and orbital-ethmoid deformity. Among these 6 patients, 2 cases accepted the cranial base reparation in order to repair the cerebrospinal fluid, Double-coronary incision combined with canine fossa approach was applied in 1 case in order to reestablish the maxillary bone and decompression of optic canal, nasal endoscope was applied in 1 case to decompress the optic canal. Results： 6 patients were satisfied with their cosmetic outlook after the surgery, no deformity and scar contracture happened in the 1-4 years＇ follow-up. Conclusions： Early stage repair for traumatic complex nasal-frontal and orbital-ethmoid fracture may be conductive to repairing nasal-frontal and orbital-ethmoid deformity、improving neural function and decreasing intracranial infection.