鼻内镜下手术治疗眶爆裂性骨折

Intranasal endoscopic surgical treatment of orbital blowout fracture

目的探讨鼻内镜手术治疗眶爆裂性骨折的手术方式、手术时机、疗效及优越性。方法回顾性分析2007—2011年诊断为眶爆裂性骨折的病例及所采取的各种术式,观察其预后及相关并发症。结果 26例眶壁骨折患者手术效果良好:15例眶内壁骨折采用鼻腔入路手术患者,术后3个月检查筛窦术腔基本完成上皮化,术后随访过程中未出现慢性鼻窦炎症状;11例眶下壁骨折患者中1例术后出现术区麻木感,3月后基本恢复正常。结论眶爆裂性骨折手术时机可以提前至伤后较短时间内;鼻内镜手术具有手术视野清晰、损伤小、并发症少的优点。

Objective To explore the surgery methods, operative opportunity, efficacy and superiority of endoscopic surgery for orbital blowout fracture. Methods Different surgical procedures were retrospectively reviewed in the cases of orbital blowout fracture diagnosed from 2007 to 2011. Results Good outcomes were achieved in the 26 patients with orbital blowout fracture, 15 of whom treated with nasal approach surgery resulted in complete epithelialization in ethmoid cavity after three months without symptoms of chronic sinusitis in postoperative follow-up process. Among the other 11 ones with inferior orbital wall fracture, one suffered from numbness in the operated area, but returned normal after three months. Conclusion It is suggested that the optimal operative opportunity should be brought forward after orbital blowout fracture and endoscopic sinus surgery possess the advantage of clear surgical field, little damage to human tissue and few complications.