鼻内窥镜微创技术在爆裂性眼眶骨折中的应用

Application of endoscopic techniques in orbital blowout fracture

目的探讨鼻内窥镜微创技术在爆裂性眼眶骨折中的应用。方法对确诊为眼眶爆裂性骨折的15例患者（15眼）行眼眶骨折修复,手术在鼻内窥镜下进行;观察比较术后创口愈合、视力、眼位、眼球突出度情况。结果所有患者创口Ⅰ期愈合,随访期间未出现植入物脱出或排斥反应;与术前比较,8例复视消失,1例复视改善但仍存在,1例复视无改善。手术不影响视力,患者视力无明显变化;患者眼位较术前改善,所有眼球运动恢复正常,1例残留部分内斜,并存在复视;术后15例眼球内陷得到不同程度的矫正,13例眼球内陷完全矫正双眼突出度基本一致,2例存在轻度内陷,术后平均内陷（0.55±0.10）mm,眼球突出度均较术前提高1.50～2.00 mm,与术前比较差异具有统计学意义。结论鼻内窥镜微创技术可以良好应用于眼眶爆裂性骨折患者,具有创伤小,恢复快的特点。

【Objective】To explore the application of minimally invasive endoscopic technique in orbital blowout fracture. 【Methods】Fifteen patients（15 eyes） diagnosed with orbital blowout fracture were performed orbital fracture repair surgery under nasal endoscope; postoperative wound healing, vision, eye position, exophthalmos case were observed and compared. 【Results】All patients were in stage Ⅰof wound healing, no implant prolapse or rejection appeared during follow-up period; compared with the preoperative condition, 8 cases of diplopia disappeared, 1 case of diplopia was improved but still existed, 1 case of diplopia was not improved. Surgery did not affect vision, there were no significant changes in visual acuity; the eye position was improved compared with the preoperative one, all eye movements returned to normal, there was 1 case with residual esotropia and diplopia; 15 cases of postoperative enophthalmos were corrected to varying degrees, 13 cases of enophthalmos were fully corrected and the degree of exophthalmos of two eyes were basically the same, there was mild retraction in two cases, after surgery an average retraction was（0.55 ±0.10） mm, compared with preoperative exophthalmos it increased 1.50 ～2.00 mm, and the difference was statistically significant. 【Conclusion】Minimally invasive endoscopic techniques can be applied well in patients with orbital blowout fracture, with the characteristics of less trauma and faster recovery.