Gönül E, Akbörü M, Izci Y, Timurkaynak E
Department of Neurosurgery, Gülhane Medical Faculty.
Minim Invasive Neurosurg. 1999 Dec;42(4):207-11. doi: 10.1055/s-2008-1053401.
We conducted a retrospective analysis of 22 patients having orbital penetrating gunshot wounds treated over a 4-years period. The neurological status and the site of injury for each patient are evaluated in this study. We propose a practical protocol in the management of these orbital foreign bodies. Surgical treatment was performed in 4 patients (had functional deficit) with medial orbitotomy in 2, lateral orbitotomy in 1, and superior orbitotomy in 1. 3 of them are improved, in one case the blindness has been continued. 18 patients were treated conservatively and all of them are improved. All patients were followed-up for 2 years with cranial X-rays and CT scans. Neurological sequelae were regressed which existed before the surgery. In conservatively treated cases, infection, migration and functional deficit were not seen. In conclusion, orbital penetrating gunshot wounds must be evaluated precisely by the surgeon and this evaluation sets the guidelines for management. The operation should be reserved for the patients in whom the necrotic soft tissues or orbital damages restrict ocular movements.
我们对4年间收治的22例眼眶穿透性枪伤患者进行了回顾性分析。本研究评估了每位患者的神经状态和损伤部位。我们提出了一种处理这些眼眶异物的实用方案。4例患者（有功能缺陷）接受了手术治疗，其中2例行内侧眶切开术，1例行外侧眶切开术，1例行上方眶切开术。其中3例病情改善，1例持续失明。18例患者接受保守治疗，均病情改善。所有患者均通过头颅X线和CT扫描进行了2年的随访。术前存在的神经后遗症有所减轻。在保守治疗的病例中，未发现感染、移位和功能缺陷。总之，外科医生必须对眼眶穿透性枪伤进行精确评估，而这种评估为治疗提供了指导原则。手术应仅用于坏死软组织或眼眶损伤限制眼球运动的患者。
