鼻内镜下取自体骨个体化治疗眶内侧壁骨折疗效分析  

Effects of endoscopic approach to Individual repair of medial orbital fracture with autogeneic bone

作　　者：叶锐 徐志华 张抗美 徐永田 冯益进 张小青 王新华 YE Rui;XU Zhihua;ZHANG Kangmei;XU Yongtian;FENG Yijin;ZHANG Xiaoqing;WANG Xinhua(Department of Otolaryngology,Hefei Binhu Hospital,Hefei 230001,China)

机构地区：[1]安徽省合肥市第一人民医院南区(滨湖医院)耳鼻咽喉科,合肥230001

出　　处：《中国眼耳鼻喉科杂志》2020年第6期483-485,492,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：合肥市卫计委应用医学研究重点项目(hwk2017zd005)。

摘　　要：目的探讨鼻内镜下经筛窦入路利用自体骨行个体化重建眶内侧壁的疗效。方法采用鼻内镜下经鼻-鼻窦入路,根据患者眶内侧缺损大小及鼻中隔形态,行个体化重建眶内侧壁治疗16例,观察患者术后眼球运动障碍、眼球凹陷、复视症状恢复情况。结果本组16例患者术后随访3~13个月,眼球运动障碍、眼球凹陷、复视基本恢复,未出现鼻中隔血肿及穿孔、眶内感染、视力下降、移植骨片脱位等并发症,仅1例患者在术后第5天因不慎挖鼻后反复出现鼻出血行鼻内镜下电凝止血术。结论经鼻内镜下鼻窦入路,利用自体鼻中隔软骨及筛骨垂直板个体化重建眼眶内侧壁,疗效较确切。Objective To study the clinical effect of endoscopic ethmoid sinus approach in the reconstruction of orbital medial with autologous bone.Methods Endoscopic transnasal approach was used,according to the defect size of medial orbit and the shape of nasal septum,16 cases of orbital wall were rebuilt individualized.We observed the recovery of patients’symptom such as eye movement disorder,enophthalmos and diplopia after operation.Results During the follow up of 3-13months after operation,all the patients recovered completely,including eye movement disorder,enophthalmos and diplopia,and had no complications,including perforation of the nasal septum,infection,diminution of vision and graft loss or displacement,except for 1 patient underwent electrocoagulation hemostasis under nasal endoscope on the 5th day after surgery due to repeated nasal bleeding after accidentally dig his nostrils.Conclusions Endoscopic approach is an effective treatment in the Individual repair of medial orbital fracture with autogeneic nasoseptal cartilage or perpendicular plate of ethmoid.

关 键 词：鼻内镜 眼眶 鼻中隔 骨折 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]