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目的评价在鼻内窥镜引导下应用自体帽状腱膜修补爆裂性眶下壁骨折的治疗效果,探讨骨折范围与手术效果的关系。设计回顾性病例系列。研究对象单纯爆裂性眶下壁骨折32例。方法对32例单纯爆裂性眶下壁骨折患者进行回顾性分析,其中眶下壁骨折范围>2cm~2者11例,≤2cm~2者2例,均存在双眼垂直复视,并对其术后视力、复视和眼球内陷矫正情况进行评价。主要指标眼球内陷程度及双眼复视程度。结果术后视力提高23例(71.9%),复视完全消失23例(71.9%),周边残留复视9例(28.1%),眶下壁骨折>2cm~2者眼球内陷矫正3例(27.3%),损伤≤2cm~2者眼球内陷矫正18例(85.7%)。结论在鼻内窥镜引导下,应用自体帽状腱膜修补爆裂性眶下壁骨折,能有效地修复眶腔,恢复眼球的运动功能,对于眶下壁骨折损伤≤2cm~2的病例效果较好。(眼科,2007,16:388-390)
Objective To evaluate the therapeutic effect of nasal endoscopic-guided autologous capsular aponeurosis to repair ruptured suborbital wall fractures and to explore the relationship between fracture range and surgical outcome. Design retrospective case series. Thirty-two cases of ruptured orbital wall fracture were studied. Methods Thirty-two patients with ruptured orbital wall fracture were retrospectively analyzed. Among them, 11 cases with orbital wall fractures> 2 cm ~ 2 and 2 cases ≤2 cm ~ 2 had vertical double vision in both eyes. Post-ocular vision, diplopia and correction of eyeball retraction were evaluated. The main indicators of eye collapse degree and binocular diplopia degree. Results Postoperative visual acuity improved in 23 cases (71.9%), diplopia disappeared completely in 23 cases (71.9%), peripheral residual double vision in 9 cases (28.1%), orbital wall fractures> 2cm ~ 27.3%), 18 cases (85.7%) of the lesions were less than or equal to 2cm ~ 2. Conclusions Under the guidance of nasal endoscope, the use of apical fascia flap to repair popliteal fractures of the inferior orbital wall can effectively repair the orbital cavity and restore the motor function of the eyeball. For cases with orbital wall fracture less than 2cm ~ 2, the effect is better it is good. (Ophthalmology, 2007,16: 388-390)