经鼻内镜柯陆进路自体耳屏软骨修复眶底骨折缺损的方法与疗效  

The treatment method and effect of orbital floor defects repaired with autologous tragus cartilage through Cald-well-Luc approach under nasal endoscope

作　　者：张家鹏[1] 文忠[2] 孙一帆[1] 黄晓明[1] 

机构地区：[1]广州中医药大学附属中山市中医院耳鼻咽喉科,广东中山528400 [2]南方医科大学附属珠江医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2012年第12期536-538,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨用自体耳屏软骨通过鼻内镜辅助下柯陆进路修复单纯眶底骨折缺损的手术方法及疗效。方法:回顾性分析15例击出性眶底骨折(暴裂性骨折)的治疗过程,取口腔前庭切口直达尖牙窝,凿开上颌窦前壁约2cm×2cm大小,鼻内镜辅助下探查眶底骨折缺损大小,取自体耳屏软骨修复。结果:术后15例均未出现视力下降、复视,无明显眼球下陷;有3例术后出现眼球轻度活动受阻,1个月后基本恢复。随访2年均无假性眼睑下垂、上眼睑陷窝加深、睑裂横径缩短及面部畸形,双眼球位置基本对称,无并发症。结论:经鼻内镜柯陆进路自体耳屏软骨修复眶底骨折缺损疗效满意、微创、操作简单且无眼面部瘢痕。To explore the operative method and effect of fracture of orbital floor defects repaired with tragus cartilage through Cald-well-Luc approach under nasal endoscope. Method： Fifteen cases suffered frac- ture of orbital floor defects（blow out fracture） were analyzed retrospectively. Oral vestibular incision were done directly to tip teeth kennel, maxillary sinus anterior forewall was chiseled with 2 cm× 2 cm size, orbital floor fracture defect size was probed under nasal endoscope, and the fracture of orbital floor defects was repaired with tragus cartilage. Resuit：Fifteen cases were successfully operated and no cases showed vision loss,diplopia, enophthalmos obviously after operation, while 3 case were a little eyeball limitation of activity and restored basically after one month. With two years of follow up, there were no spurious eyelid drooping, upeyelid lacuna deepen, eyelid diameter shorten and facial deformity were found. Both eye balls were basical symmetry and no complications were hap pened. Conclusion.. It is a satisfactory, effective and aminimally invasive surgical method without facial scars and eyelid ectropion for fracture of orbital floor defects repaired with tragus cartilage through Cald-well-Luc approach under nasal endoscope.

关 键 词：鼻内镜 柯陆进路 耳屏软骨 眶底骨折缺损 

分 类 号：R779.6[医药卫生—眼科]