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鼻内镜下经鼻眶底爆裂骨折复位术

Endoscopic endonasal reduction of blowout fractures of the orbital floor.

作者信息

Hinohira Yasuyuki, Yumoto Eiji, Shimamura Ichiro

机构信息

Department of Otolaryngology, Takanoko Hospital, Ehime-ken, Japan.

出版信息

Otolaryngol Head Neck Surg. 2005 Nov;133(5):741-7. doi: 10.1016/j.otohns.2005.07.038.

Abstract

OBJECTIVES

The aim of this study was to document the usefulness of the endoscopic endonasal approach as a surgical treatment of isolated blowout fractures of the orbital floor.

STUDY DESIGN

Retrospective study.

SETTING

Between 1997 and 2003, using only an endonasal endoscopic surgical approach, we operated on 62 patients complaining of diplopia due to isolated blowout fractures of the orbital floor. In order to perform the endonasal reduction surgery, supplemental septoplasty and/or submucous conchotomy were done. Immediately following the reduction and the fixation, eye traction tests were performed to confirm the ocular motility improvement. Tampon gauzes or balloon catheters were used for the temporal fixation to support the orbital floor.

RESULTS

Postoperatively, diplopia completely disappeared in 55 of the 62 patients (88.7%) that were followed over 6 months.

CONCLUSION

The high success rate with regard to diplopia indicates that the endoscopic endonasal approach may be an alternative to extranasal methods.

EBM RATING

B-3.

摘要

目的

本研究旨在记录鼻内镜经鼻入路作为眶底孤立性爆裂骨折手术治疗方法的有效性。

研究设计

回顾性研究。

研究背景

1997年至2003年间,我们仅采用鼻内镜手术入路,对62例因眶底孤立性爆裂骨折而出现复视的患者进行了手术。为了进行鼻内复位手术,还进行了补充鼻中隔成形术和/或黏膜下鼻甲切除术。复位和固定后,立即进行眼球牵引试验以确认眼球运动改善情况。使用棉塞纱布或球囊导管进行颞部固定以支撑眶底。

结果

术后,62例患者中有55例(88.7%)在随访6个月以上时复视完全消失。

结论

复视的高成功率表明鼻内镜经鼻入路可能是鼻外方法的一种替代方法。

循证医学等级

B-3。

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