鼻内镜治疗眼眶爆裂性骨折疗效观察

Clinical Effects of Nasal Endoscopy for Orbital Blowout Fracture Patients

目的观察鼻内镜微创技术治疗眼眶爆裂性骨折的疗效。方法2018年1月至2021年5月,对眼眶爆裂性骨折的15例患者行鼻内镜微创技术治疗,总结其临床疗效。结果所有患者均顺利完成鼻内镜手术,无中转开放手术者,术后平均住院2.5(1~7)天。本组患者中术前复视9例,术后复视早期消失1例,有2例出现较明显斜视,余6例早期无明显改变;术前眶下神经感觉减退麻木8例,术后眶下神经感觉正常2例,无明显改善6例。10例眼球后退患者均得以改善,术后眼球后退均小于2mm。所有患者术后视力无下降。15例患者术后均行眼肌功能训练,复视及眼球运动障碍均消失,斜视明显改善,眼球运动良好,面部无瘢痕。术后随访12~36个月,无复发,无排异反应。结论鼻内镜微创技术治疗眼眶爆裂性骨折疗效确切,具有创伤小、恢复快的优点,值得临床推广。

Objective To observe the clinical effects of nasal endoscopy for orbital blowout fracture patients.Methods Clinical effects were summarized in 15 patients underwent nasal endoscopy for orbital blowout fractures from January 2018 to May 2021.Results All patients successfully completed nasal endoscopic surgery without open-conversion.The postoperative average hospital stay was 2.5(1~7)days.In the 9 cases who had preoperative diplopia,1 case had early recovery after operation,2 cases had obvious strabismus,and the other 6 cases had no obvious early change.In the 8 cases with preoperative hypoesthesia and numbness of infraorbital nerve,2 cases improved after surgery and 6 cases had no change.10 cases of eyeball retraction improved,and the eyeball retraction was less than 2mm after operation.And their visual acuity did not decrease after operation.In all the 15 patients who underwent eye muscle function training,their diplopia and eye movement disorder disappeared,strabismus recovered significantly without facial scar.There was no recurrence or rejection in all patients during 12~36 months follow-up.Conclusion It is effective,mini-trauma and rapid recovery of nasal endoscopy for orbital blowout fractures,which is worthy of clinical promotion.