Cohen Seth M, Garrett C Gaelyn
Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA.
Otolaryngol Head Neck Surg. 2003 Jul;129(1):43-7. doi: 10.1016/S0194-59980300487-X.
We sought to explore whether nausea and vomiting are predictive of entrapment. Study design and setting We retrospectively evaluated the data regarding orbital floor fractures in children younger than 19-years-old presenting at a tertiary care center from 1990 to 2001. Zygomatic, naso-orbital ethmoid, and displaced orbital rim fractures were excluded from our analysis. Data on the fracture type, signs and symptoms, ocular motility, surgical repair, and resolution of diplopia were also collected.
Twenty-nine orbital floor fractures were identified. One fourth of the children had nausea/vomiting, and half had trapdoor fractures. Seventeen percent of patients had entrapment of the inferior rectus. The positive predictive value of nausea/vomiting with a trapdoor fracture for entrapment was 83.3% (P = 0.002, Fisher exact test). Half the patients required surgical intervention, most commonly for diplopia or gaze restriction. Gaze impairment did not resolve in 2 patients.
Patients with trapdoor fractures who present with nausea/vomiting are at a high risk of inferior rectus entrapment and poor outcome.
我们试图探究恶心和呕吐是否可预测眼球陷顿。研究设计与背景 我们回顾性评估了1990年至2001年在一家三级医疗中心就诊的19岁以下儿童眼眶底骨折的数据。颧骨、鼻眶筛和移位的眶缘骨折被排除在我们的分析之外。还收集了有关骨折类型、体征和症状、眼球运动、手术修复及复视消退情况的数据。
共识别出29例眼眶底骨折。四分之一的儿童有恶心/呕吐，一半有活板门骨折。17%的患者存在下直肌陷顿。活板门骨折伴恶心/呕吐对陷顿的阳性预测值为83.3%（P = 0.002，Fisher精确检验）。一半的患者需要手术干预，最常见的原因是复视或注视受限。2例患者的注视障碍未得到缓解。
伴有恶心/呕吐的活板门骨折患者发生下直肌陷顿及预后不良的风险较高。
Zotero 插件