鼻眶筛并发颧骨骨折伴发症解剖研究现状

doi:10.6040/j.issn.1673-3770.0.2023.461

摘要/Abstract

摘要： 鼻眶筛(naso-orbito-ethmoid, NOE)位于面中部多块骨的交汇处,结构复杂,其单独骨折的概率很低,常并发面部其他骨折,其中最常并发颧骨骨折。NOE并发颧骨骨折的病因多为高能量的钝性损伤,故常伴随多种面部其他损伤,由于NOE区及颧骨均邻近眼眶,故NOE并发颧骨骨折时可出现大量眼部伴发症,轻度伴发症的发病率较高,严重伴发症的发病率低。以NOE区骨折为主的并发骨折的伴发症以内眦间距过宽等靠近内侧的组织损伤为主,以颧骨骨折为主的并发骨折的伴发症以眼球运动受限等靠近外侧的组织损伤为主,NOE区及颧骨骨折均较严重的并发骨折多伴发失明、颅脑损伤等严重伴发症。NOE并发颧骨骨折的主要机制是能量从撞击点沿着面中部的垂直和水平支柱向面中部支柱向周围传播,能量随着传播距离的增加逐渐衰减,在能量传播过程中,鼻窦可通过变形和骨折吸收部分能量从而对颅脑和眼球有一定的保护作用。

关键词: 鼻眶筛骨折, 颧骨骨折, 解剖, 并发症, 机制

Abstract: The naso-orbito-ethmoid(NOE)is located at the intersection of multiple bones in the middle of the face. Its structure is complex and the probability of its fracture alone is very low. It often co-occurs with other facial fractures, most commonly zygomatic bone fractures. The cause of NOE concurrent with zygomatic bone fractures is often high-energy blunt trauma, so it often accompany various other facial injuries. Since the NOE area and the zygomatic bone are adjacent to the orbit, a large number of ocular complications can occur when NOE co-occurs with zygomatic bone fractures. The incidence of mild complications is relatively high, while the incidence of severe complications is low. The complications of concurrent fractures that involve mainly the NOE area are mainly tissue injuries close to the medial side, such as an excessive medial canthal distance. The complications of concurrent fractures mainly involving zygomatic bone are mainly tissue injuries close to the lateral side, such as limited eye movement. Concurrent fractures in both the NOE area and the zygomatic bone are often accompanied by serious complications such as blindness and cranial injury. The main mechanism of NOE concurrent with zygomatic bone fractures is that the energy from the impact point spreads along the vertical and horizontal pillars of the middle part of the face to the surrounding areas of the middle pillar, and the energy gradually attenuates with increasing propagation distance. During the energy propagation process, the sinuses can absorb some energy through deformation and fracture, thus providing a certain protective effect on the skull and eyeball.

Key words: Naso-orbito-ethmoid fracture, Zygomatic bone fracture, Anatomy, Complications, Mechanism

中图分类号:

R765.8

马莉,高瞻,李鹏起,倪前伟. 鼻眶筛并发颧骨骨折伴发症解剖研究现状[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 126-130.

MA Li, GAO Zhan, LI Pengqi, NI Qianwei. Current status of anatomical research on nasal orbital ethmoid and concurrent zygomatic bone fracture complications[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(5): 126-130.

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