山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (5): 79-81.doi: 10.6040/j.issn.1673-3770.0.2019.022

• 论著 • 上一篇    下一篇

经上颌窦径路修复眶下壁骨折伴眶内容脱垂及下直肌嵌顿

刘玉柱1,高英恺1,2(),蒋贵云3,裴皓旭4,岳小雪4   

  1. 1. 潍坊医学院研究生院耳鼻喉教研室,山东 潍坊 261053
    2. 潍坊医学院附属潍坊市中医院耳鼻喉科,山东 潍坊 261041
    3. 枣庄市中医院耳鼻喉科,山东 枣庄 277101
    4. 山东中医药大学研究生院耳鼻喉教研室,山东 济南 250014
  • 收稿日期:2019-01-11 修回日期:2019-05-23 出版日期:2019-09-20 发布日期:2019-10-15
  • 通讯作者: 高英恺 E-mail:wfebh@163.com

Surgical repair of orbital floor fracture with content prolapse and inferior rectus incarceration through maxillary sinus approach

Yuzhu LIU1,Yingkai GAO1,2(),Guiyun JIANG3,Haoxu PEI4,Xiaoxue YUE4   

  1. 1. Department of Otolaryngology, Weifang Medical University, Weifang 261053, Shandong, China
    2. Department of Otolaryngology, Weifang Hospital of Traditional Chinese Medicine, Weifang Medical College, Weifang 261041, Shandong, China
    3. Department of Otolaryngology, Zaozhuang Hospital of Traditional Chinese Medicine, Zaozhuang 277101, Shandong, China
    4. Department of Otolaryngology, Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong, China
  • Received:2019-01-11 Revised:2019-05-23 Online:2019-09-20 Published:2019-10-15
  • Contact: Yingkai GAO E-mail:wfebh@163.com

摘要: 目的

探讨经上颌窦径路鼻内窥镜下眶下壁骨折伴眶内容脱垂及下直肌嵌顿复位及手术修复的疗效。

方法

选取2002年 1 月~2017 年12月收治的眶下壁骨折伴眶内容脱垂及下直肌嵌顿患者7例,均采用上颌窦径路鼻内窥镜下眶下壁骨折复位术、眶内容物还纳术及下直肌嵌顿松解术,以Foley氏尿道球囊导管支撑眶底。

结果

术后14d抽出上颌窦球囊导管,7例患者复视均消失,眼位及眼球运动恢复正常。7例患者视力较术前均无改变。

结论

经上颌窦径路眶下壁骨折伴眶内容脱垂及下直肌嵌顿的复位及手术修复,具有创伤小、无面部切口、视野清晰、手术空间广等优点。

关键词: 眶下壁骨折, 经上颌窦径路, 手术修复

Abstract: Objective

To explore the effects of surgical repair of orbital floor fracture with content prolapse and inferior rectus incarceration through the maxillary sinus approach.

Methods

From January 2002 to December 2017, 7 patients with orbital floor fracture with content prolapse and inferior rectus incarceration were treated in our hospital. The patients underwent nasal endoscopic reduction of orbital floor fracture through the maxillary sinus approach, restoration of content prolapse, and lysis of inferior rectus incarceration, supporting the bottom with a Foley′s urethral balloon catheter.

Results

The maxillary sinus balloon catheter was withdrawn 14 days after the surgery. Seven cases of double vision disappeared, and the eye position and movement returned to normal. Seven patients had no change in visual acuity compared to their preoperative values.

Conclusion

Surgical repair through the maxillary sinus approach of orbital floor fracture with sacral content prolapse and inferior rectus incarceration reduction is characterized by less trauma, no incision on the face, clear visual field, and wide space available for operation.

Key words: Orbital floor fracture, Maxillary sinus approach, Surgical repair

中图分类号: 

  • R770.4

图1

患者术前CT结果。 a.轴位; b. 冠位"

图2

患者术后CT结果。 a.轴位; b. 冠位"

1 赵娟, 徐金操 . 鼻内镜下眶下壁骨折修复方式及材料应用研究进展[J]. 中国临床医学, 2018, 25(2): 314-317. doi: 10.12025/j.issn.1008-6358.2018.20170715 .
doi: 10.12025/j.issn.1008-6358.2018.20170715
ZHAO Juan , XU Jincao . Research progress of repair methods and materials of orbital wall fracture with nasal endoscopy[J]. Chinese Journal of Clinical Medicine, 2018, 25(2): 314-317. doi: 10.12025/j.issn.1008-6358.2018.20170715 .
doi: 10.12025/j.issn.1008-6358.2018.20170715
2 江新利, 苗慧鹏, 周忠友, 等 . 眶下壁骨折不同径路修复手术的效果比较[J]. 中华眼外伤职业眼病杂志, 2016, 38(5): 340-343. doi:10.3760/cma.j.issn.2095-1477.2016.05.005 .
doi: 10.3760/cma.j.issn.2095-1477.2016.05.005
JIANG Xinli , MIAO Huipeng , ZHOU Zhongyou , et al . Comparison of the different approaches of reconstruction surgery for orbital floor fracture[J]. Chinese Journal of Ocular Trauma and Occupational Eye Disease, 2016, 38(5): 340-343. doi:10.3760/cma.j.issn.2095-1477.2016.05.005 .
doi: 10.3760/cma.j.issn.2095-1477.2016.05.005
3 明华伟, 何芸, 夏德林, 等 . 下睑结膜外眦径路在眶下缘和眶底骨折治疗中的应用[J]. 中国美容医学, 2016, 25(6): 51-54. doi:10.15909/j.cnki.cn61-1347/r.001196 .
doi: 10.15909/j.cnki.cn61-1347/r.001196
MING Huawei , HE Yun , XIA Delin , et al . Clinical application of transconjunctival approach which combined with lateral canthus incision to treat fractures of the orbital floor and infraorbital rim[J]. Chinese Journal of Aesthetic Medicine, 2016, 25(6): 51-54. doi:10.15909/j.cnki.cn61-1347/r.001196 .
doi: 10.15909/j.cnki.cn61-1347/r.001196
4 杨振, 丁刚, 陈璇, 等 . 眶下壁骨折伴下直肌嵌顿的手术疗效观察[J]. 中华眼外伤职业眼病杂志, 2017, 39(12): 943-945. doi:10.3760/cma.j.issn.2095-1477.2017.12.016 .
doi: 10.3760/cma.j.issn.2095-1477.2017.12.016
YANG Zhen , DING Gang , CHEN Xuan , et al . Observation on the efficacy of surgeries for the treatment of orbital floor fractures associated with inferior rectus incarceration[J]. Chinese Journal of Ocular Trauma and Occupational Eye Disease, 2017, 39(12): 943-945. doi:10.3760/cma.j.issn.2095-1477.2017.12.016 .
doi: 10.3760/cma.j.issn.2095-1477.2017.12.016
5 陶晶, 卢永田, 王晓彬, 等 . 经鼻内镜处理眶内及眶壁病变[J]. 山东大学耳鼻喉眼学报, 2014, 28(4): 40-42. doi: 10.6040/j.issn.1673-3770.0.2014.122 .
doi: 10.6040/j.issn.1673-3770.0.2014.122
TAO Jing , LU Yongtian , WANG Xiaobin , et al . Management of the intraorbital and orbital wall disease by the intranasal endoscopic approach[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2014, 28(4): 40-42. doi: 10.6040/j.issn.1673-3770.0.2014.122 .
doi: 10.6040/j.issn.1673-3770.0.2014.122
6 章华, 范若皓, 谢志海, 等 . 内镜下中鼻道联合泪前隐窝径路治疗眶壁骨折[J]. 临床耳鼻咽喉头颈外科杂志, 2015, 29(3): 246-249. doi:10.13201/j.issn.1001-1781.2015.03.014 .
doi: 10.13201/j.issn.1001-1781.2015.03.014
ZHANG Hua , FAN Ruohao , XIE Zhihai , et al . Combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2015, 29(3): 246-249. doi:10.13201/j.issn.1001-1781.2015.03.014 .
doi: 10.13201/j.issn.1001-1781.2015.03.014
7 Kuhnel T , Jagle H , Hosemann W , et al . Orbital floor fracture repair: the endonasal approach[J]. Rhinology, 2017, 55(4): 348-354. doi:10.4193/Rhin16.334 .
doi: 10.4193/Rhin16.334
8 Soejima K , Shimoda K , Kashimura T , et al . Endoscopic transmaxillary repair of orbital floor fractures: a minimally invasive treatment[J]. J Plast Surg Hand Surg, 2013, 47(5): 368-373. doi:10.3109/2000656X.2013.769443 .
doi: 10.3109/2000656X.2013.769443
9 李璐鑫, 冀永进, 刘荣, 等 . 鼻内镜下泪前隐窝径路治疗眶底壁骨折[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(2): 157-159. doi: 10.13201/j.issn.1001-1781.2019.02.015 .
doi: 10.13201/j.issn.1001-1781.2019.02.015
LI Luxin , JI Yongjin , LIU Rong , et al . Expand prelacrimal recess-maxillary ainus approach for inferior orbital walls fracture treatment[J]. Journal of Clinical Otorhinolaryngology, 2019, 33(2):157-159. doi: 10.13201/j.issn.1001-1781.2019.02.015 .
doi: 10.13201/j.issn.1001-1781.2019.02.015
[1] 乔岗,代艳,郭海科,郭道林,卫云峰,李娟. 超声造影在诊断困难的视网膜脱离、脉络膜脱离及眼内肿块中的应用[J]. 山东大学耳鼻喉眼学报, 2016, 30(2): 91-93.
[2] 孙娟,张淑娥,杨立新. 首诊于眼科的急性淋巴细胞白血病1例[J]. 山东大学耳鼻喉眼学报, 2014, 28(3): 91-92.
[3] 赵军,陈尧,秦建民. 青年人不同程度近视24°蓝黄视野检测结果的研究[J]. 山东大学耳鼻喉眼学报, 2013, 27(5): 59-61.
[4] 李莹,李悦,罗岩,金玉梅. Pentacam前节分析系统测量角膜厚度、地形图及屈光手术后角膜后表面的研究[J]. 山东大学耳鼻喉眼学报, 2011, 25(5): 82-.
[5] 汪新1综述, 魏伟2审校. 弱视发病机制的多焦电生理及影像学研究现状[J]. 山东大学耳鼻喉眼学报, 2011, 25(1): 68-71.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!