Raveh J, Laedrach K, Vuillemin T, Zingg M
Department of Craniomaxillofacial Surgery, University of Bern, Switzerland.
Arch Otolaryngol Head Neck Surg. 1992 Jun;118(6):605-14. doi: 10.1001/archotol.1992.01880060053014.
In regard to the multiple problems of reconstruction concerning this fracture pattern, we developed various methods to achieve optimal results. As various vital regions, apart from the nasoethmoidal fractures and aesthetics, are involved, the proposed classification has direct implication for the surgical procedure. Even in intracranial fragment dislocations, cerebral contusion, and elevated intracranial pressure, the subcranial approach, in contrast with the transfrontal access, enables early definitive management of the skull base and the external facial frame in a one-stage procedure. Another method, the symmetrical centripetal compression of the canthal ligaments and naso-orbital bone fragments, enables correct reduction of the telecanthus. The significant reduction of morbidity and complication rate to a minimum confirms the efficiency of our treatment modalities.
针对这种骨折类型重建的多个问题，我们开发了多种方法以取得最佳效果。由于除鼻筛骨骨折和美观问题外，还涉及多个重要区域，因此所提出的分类对手术操作有直接影响。即使存在颅内骨折片脱位、脑挫伤和颅内压升高的情况，与经额入路相比，颅下入路能够在一期手术中对颅底和面部外框架进行早期确定性处理。另一种方法，即对眦韧带和鼻眶骨碎片进行对称向心压缩，能够正确复位远距眦。将发病率和并发症率显著降至最低证实了我们治疗方式的有效性。
