一体钛网整体修复眼眶骨折后眼球内陷的原因  

Postoperative enophthalmos in inner and inferior orbital fracture repaired by titanium mesh

作　　者：王树纲[1] 邹吉新[1] 张繁友[1] 

机构地区：[1]大连市第三人民医院眼科,辽宁大连116021

出　　处：《中华眼外伤职业眼病杂志》2013年第6期434-435,共2页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：【摘要】目的探讨经一体钛网材料整体修复眼眶内壁合并下壁骨折术后眼球内陷的原因。方法眼眶内壁合并下壁骨折术后眼球内陷改善不理想6例，研究其手术方法、植入材料及影像学表现。结果6例术前为眼球内陷3～4mm，术前计算机断层成像（CT）显示骨折范围大，眶内容物大量脱出，“隅角”移位；手术中使用一体钛网材料同时修复内壁及下壁。术后残余2mm的眼球内陷，2例复视。术后CT显示6例存在钛网后缘向筛窦移位，后部眶腔重建不理想，1例复视者存在眶内容旋转，眼外肌移位情况，1例骨膜下出血，眼球上移位。结论眼眶内壁合并下壁骨折手术难度较大，直视下找到正常解剖标志点，采用个体化手术方案，合理选择手术材料，才能达到较好的效果。Objective To explore the causes of postoperative enophthalmos in inner and inferior or- bital fracture repaired by titanium mesh. Methods Six cases with inner and inferior orbital fracture repaired by titanium mesh were studied, whose postoperative symptoms were residual enophthalmos. Operative meth- od, implant material, and imagining manifestation were studied. Results Preoperatively, 6 cases showed 3 ~ 4 mm enophthalmos, CT showed fractures of orbital contents in large range, large number of prolapse , and ＂corner＂ shife. In operation, one titanium mesh was used to repair the fracture. Postoperative patients showed 2 mm enophthalmos in all these cases, and diplopia in 2 patients ; postoperative CT showed the shift of titanium mesh edge to ethmoid sinus, posterior orbital reconstruction is not ideal; in one diplopia case, CT showed rotation of orbital content and extraocular muscle transposition. Besides, subperiosteal hemorrhage and eyeball displacement were showed in the other diplopia case. Conclusion Operational difficulty in or- bital fracture with inner and inferior wall is great. Normal anatomical landmark found under direct vision, in- dividual operation scheme, reasonable choice of operation material are required for successful surgery.

关 键 词：眼眶骨折 眼球内陷 

分 类 号：R779.6[医药卫生—眼科]