经鼻内镜处理内直肌嵌顿的方法与疗效分析

Endonasal endoscopic surgery in treatment of medial recus muscle entrapment:the management and effectiveness

目的:探讨采用鼻内镜技术治疗内直肌嵌顿的适应症、方法和疗效。方法:8例内直肌嵌顿患者,3例于鼻内镜下行眶内壁骨折整复内直肌粘连分解术,5例行内镜下经鼻腔及泪阜结膜切口双径路手术。结果:6例患者在2个月内复视消失,眼球外展功能恢复;1例单纯经鼻内镜下眶内壁骨折整复手术及1例鼻内镜下双径路手术患者遗留轻度复视和外展受限。结论:鼻内镜手术视野清晰、损伤较小,在伤后3周内采用经鼻或经鼻和经眶双径路手术可有效治疗内直肌嵌顿患者。

Objective：To explore the indications,surgery method and effect for the treatment of medial rectus muscle entrapment with endoscopic surgery.Method：Eight medial rectus muscle entrapment patients were enrolled in this study,3cases underwent obital medial wall fracture reposition and medial rectus muscle adhesion decomposition surgery through endonasal endoscope,and 5cases received obital medial wall fracture reposition surgery with endoscope through nasal cavity and lacrimal caruncle conjunctival incision.Result：The diplopia disappeared and eyeball abduction function recovered in 6cases of medial rectus muscle entrapment patients within 2months,and 1case with each surgery had mild diplopia and eyeball incomplete abduction left.Conclusion：Adopting endonasal endoscopic surgery or dual approaches surgery with endonasal endoscopic and transcaruncular surgery were ideal methods for medial rectus muscle entrapment diseases.Surgery with endoscope has the characteristics of clear field and less damage.The surgery should be performed whithin 3weeks,and the entrapment of medial rectus muscle can be resoved effectively.