鼻内镜手术在眼眶骨折中的应用

Application of nasal endoscopy to orbital fractures

传统的眼眶骨折手术是经皮肤或结膜的直接途径,能提供良好的手术视野,但手术创伤大,皮肤遗留瘢痕。鼻内镜手术照明好、多角度、视野清晰、入路简捷、可以微创的手术处理达到最佳的手术效果。鼻内镜下经筛窦/上颌窦入路适于复位单纯的眶壁骨折,直视眶壁后份骨折的骨质缺损以及突入到窦腔的眼眶内容物,并辅助眼眶骨折的临床诊断。鼻内镜手术联合其他经鼻外皮肤或结膜的入路,在修复鼻眶筛复合体骨折时优势明显。本文就鼻内镜在眼眶骨折中的诊断价值、鼻内镜手术治疗眼眶骨折的优缺点和临床指征、操作要点、植入材料以及骨折固定材料等方面作一综述。

Transcutaneous or transconjunctival approaches offer fine surgery field to the repair of orbital fractures,yet remaining invasively surgical scar.Nasal endoscopy achieves great success in diagnosis and reduction of isolated orbital wall fractures,as well as better view of fractures of posterior orbital wall fractures and orbital contents entrapped into sinus,owing to accessible and minimally invasive surgical approaches and excellent illumination.Endoscopic sinus approach associated with transcutaneous or transconjunctival excisions represent advantages in repairing fractures of naso-orbital-ethmoidal complex.Here we review the diagnostic value,strengths and weaknesses,clinical indications,surgical technique,implant materials and fixation materials involving in nasal endoscopy repairing orbital fractures.