眶颧复合体骨折后眼球内陷的手术治疗  

Surgical techniques for orbitalzygomatic complex fracture

作　　者：李瑾[1] 范先群[1] 林明[1] 周慧芳[1] 陆雯娟[1] 

机构地区：[1]中国上海交通大学医学院附属第九人民医院眼科,200011

出　　处：《国际眼科杂志》2008年第10期2055-2058,共4页International Eye Science

基　　金：中国上海市优秀学科带头人计划项目资助(No.07XD14020)~~

摘　　要：目的:眶颧复合体骨折后眼球内陷的手术矫正方法及其疗效。方法:回顾性分析1999-01/2006-05我院眼科收治的45例眶颧复合体骨折合并眼球内陷患者行骨折复位和眼眶重建的手术资料和随访结果。其中早期手术11例,晚期手术34例。通过眉弓外侧切口、下睑切口、前庭沟切口和冠状切口联合入路,在建立良好咬合关系的基础上,恢复和加强眶颧复合体正常解剖结构,微型钛板坚强内固定,Medpor充填修复眶壁骨折矫正眼球内陷。45例患者术后随访12～30mo。结果:所选45例患者术后外观获得显著改善,眼球内陷矫正,复视得到改善。早期手术病例组骨折复位和功能恢复均优于晚期组。结论:眶颌颧复合体骨折手术可以恢复正常面中部外形、矫正眼球内陷和改善复视症状。早期手术更容易达到解剖复位,提高疗效。AIM. To study the surgical technique for orbitalzygomatic complex fracture. METHODS. Retrospective non-comparative case series of 45 patients with orbitalzygomatic complex fracture which were treated in the Department of Ophthalmology, the Ninth People＇s Hospital, Medical School of Shanghai Jiaotong University from January 1999 to December 2006. Eleven patients accepted surgical treatment in 2 weeks after trauma, and 35 patients accepted late opera-tion. Lateral brow incisions, inferior eyelid incisions, coronal incisions and intraoral incisions applied in 45 patients, through which fracture lines of suborbital edge, outside and inferior walls of orbital cavity, zygomatic arch were exposed. After accurate reduction, mini titanium bone plates were used to stabilize the fractured bones, and the orbital surgery for the reposition of enophthalmos was performed at the same time. All patients were followed up for 12-30 months. RESULTS： After the orbitalzygomatic complex fracture repair, all cases obtained excellent appearance and function. The postoperative enophthalmos degree was 0-2mm, and the infra-shift of orbit was 0-2mm. Early operation got better results than late operation. CONCLUSION： Surgical treatment is safe and effective for orbitalzygomatic complex fracture. Early operation will obtain more satisfied results.

关 键 词：眶颧复合体 骨折 手术 

分 类 号：R779.6[医药卫生—眼科]