钛网植入治疗眼眶内下壁爆裂性骨折眼球内陷  

Titanium mesh implantation for the treatment of enophthalmos caused by blow-out fractures of orbital medial and inferior walls

作　　者：于金国[1] 张静楷[1] 陈松[1] 韩琪[1] 颜华[1] 

机构地区：[1]天津医科大学总医院眼科,300052

出　　处：《中华眼外伤职业眼病杂志》2015年第9期641-644,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨钛网植入治疗眼眶内下壁爆裂性骨折后眼球内陷的效果。方法回顾性分析11例（11只眼）眼眶内下壁爆裂性骨折行钛网植入手术的临床资料。术前眼球内陷4．0—6．5mm，伴双暇复视者2例，眼球下移位者4例。手术人路为下睑缘切口联合鼻侧皮肤切口，分别于骨膜下植入钛网覆盖眶内壁及下壁骨折缺损区。结果术后随访7—11个月，眼球内陷均矫正至1mm以内，2例复视完全消失，4例眼球移位均完全矫正。术后无感染、植入物脱出、排斥或移位等并发症。结论单纯应用钛网治疗眼眶内下壁爆裂性骨折引起的眼球内陷安全有效，重建眶腔特殊解剖形态、完全还纳脱出的眶内容物是治疗的关键。Objective To evaluate the effect of titanium mesh implantation for enophthalmos secondary to blow-out fractures of orbital medial and inferior walls. Methods The surgical effects of 11 cases （11 eyes ） of blow-out fractures of orbital medial and inferior walls who received titanium mesh implantation for orbital reconstruction were analyzed retrospectively. Preoperatively, all cases showed 4.0 to 6.5mm enophthalmos among whom 2 cases had diplopia and 4 cases had apparent vertical globe dystopia. For all the eases, inferior subciliary approach combined with nasal lateral approach were performed, and 2 titanium mesh plates were implanted under the periosteum to cover the area of the inferior and medial orbital wall fracture respectively in order to reconstruct the normal orbital cavity. Results Postoperatively, after a followed up period of 7-11 months, the enophthalmos of all cases was corrected to less than I mm successfully ~ the preoperative diplopia disappeared in all the 2 cases, the vertical globe dystopia of 4 cases disappeared totally, and no complication such as infection, extrusion, rejection or migration of the implants occurred. Conclusion Titanium mesh plates implantation only is safe and effective to correct the enophthalmos secondary to blow-out fractures of orbital medial and inferior walls, and the key is reconstruction of the special orbital shape and complete returning soft tissue into orbital cavity.

关 键 词：眶骨折 爆裂性 眼球内陷 钛网 植入 

分 类 号：R779.6[医药卫生—眼科]