姿势性高低眼畸形的病因和临床特点及分度的探究

Exploration of the Etiology,Clinical features and Grading of Postural Asymmetrical Eyes Deformity

目的:探讨姿势性高低眼畸形的病因及临床特点,制定畸形分度,为患者诊治提供依据。方法:分析2008年1月-2020年6月笔者医院收治的31例姿势性高低眼畸形病例的临床资料,总结其病因及临床特点,制作高低眼畸形患者分度模拟图,以问卷调查的形式,探究人群对此畸形分度的评判,制定临床畸形分度。结果:姿势性高低眼畸形患者大多有先天性肌性斜颈和寰枢椎半脱位病史,即患者长期头部偏斜状态造成婴幼儿至青少年期面中部骨骼因重力原因发育畸形,其主要特征为瞳间线与骨性鼻长轴不成直角,而骨性鼻长轴基本与下面部中线基本重合。临床分度:瞳间线偏斜0°~1°为正常,1°~3°为轻度,3°~5°为中度,5°~7°为重度,>7°为极重度。结论:姿势性高低眼畸形是瞳间线与骨性鼻长轴不成直角的面部偏斜畸形。瞳间线偏斜大于5°以上的严重病例可能与患者儿童时期的寰枢椎半脱位或先天性斜颈病史有关。

Objective To explore the etiology and clinical features of postural asymmetrical eyes,and to formulate the malformation classification,so as to provide a basis for diagnosis and treatment of patients.Methods The clinical data of 31 cases of postural asymmetrical eyes admitted to the author's hospital between January 2008 and June 2020 were analysed to summarize the etiology and clinical features,to make a deformity simulation diagram,to explore the population's judgment of this deformity index in the form of a questionnaire survey and to develop clinical deformity index.Results Most of the postural asymmetrical eyes patients had a congenital muscular torticollis or atlantoaxial rotatory subluxation,where the patient has the long head deviation state of the patient caused developmental deformity of the midfacial skeleton due to gravity during infancy to adolescence.The main feature is that the interpupillary line is not at right angle to the bony nasal long axis,while the bony nasal long axis basically coincides with the lower facial midline.Clinical grading:the skewing of the interpupillary line is normal from 0°-1°,mild from 1°-3°,moderate from 3°-5°,severe from 5°-7°,extremely severe>7°.Conclusion Postural asymmetrical eyes is a facial deviation deformity in which the interpupillary line is not at right angle to the bony nasal long axis.Severe cases with the skewing of the interpupillary line greater than 5°may be associated with congenital muscular torticollis and atlantoaxial rotatory subluxation in patient's childhood.