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[眶下木质异物伤后继发性黑矇]

[Secondary amaurosis after infraorbital injury with a wooden foreign body].

作者信息

Sandner A, Kösling S, Heider C, Bloching M B

机构信息

Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie der Martin-Luther-Universität Halle-Wittenberg, Halle/Saale.

出版信息

HNO. 2007 Jun;55(6):481-4. doi: 10.1007/s00106-006-1406-7.

DOI:10.1007/s00106-006-1406-7
PMID:16601992
Abstract

We report a 68-year-old male who had orbital trauma from a bicycle accident. His vision was initially normal but deteriorated over 8 days to complete blindness. After 13 days, when he first consulted a physician, clinical investigation revealed total ophthalmoplegia, ptosis, and chemosis. Computed tomographic scan showed fractures of the medial orbital wall, orbital floor, and posterior ethmoid with dislocation into the orbital apex near the optic nerve. The patient was sent to our department for optic nerve decompression. Clinical examination showed induration and an already healed infraorbital entry wound suggesting an orbital foreign body, which was confirmed by ultrasound. Renewed analysis of CT scans in different window settings could clearly demonstrate a wooden foreign body in the lower eyelid. Additionally, a diffuse inflammation in the orbital apex was diagnosed. The foreign body was removed and decompression of the orbita and optic nerve was performed. Antibiotics and corticosteroids were administered i.v. Unfortunately, no visual improvement could be achieved.

摘要

我们报告一例68岁男性,因自行车事故导致眼眶外伤。其视力最初正常,但在8天内逐渐恶化至完全失明。13天后,他首次就诊时,临床检查发现完全性眼肌麻痹、上睑下垂和球结膜水肿。计算机断层扫描显示眶内侧壁、眶底和后筛窦骨折,并伴有向视神经附近眶尖的移位。患者被送至我科行视神经减压术。临床检查发现硬结及已愈合的眶下入口伤口,提示存在眶内异物,超声检查证实了这一点。在不同窗宽设置下对CT扫描进行重新分析,可清晰显示下眼睑内的木质异物。此外,诊断为眶尖弥漫性炎症。取出异物并进行眶和视神经减压术。静脉注射抗生素和皮质类固醇。不幸的是,视力未能改善。

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引用本文的文献

1
[Intraorbital wooden foreign body undetected on CT].[眼眶内木质异物在CT上未被检测到]
HNO. 2010 Dec;58(12):1237-40. doi: 10.1007/s00106-010-2192-9.

本文引用的文献

1
[Orbital foreign bodies -- diagnostics, therapy and management].[眼眶异物——诊断、治疗与处理]
Laryngorhinootologie. 2005 Mar;84(3):187-92. doi: 10.1055/s-2004-826069.
2
Retained intraorbital metallic foreign bodies.眼眶内金属异物残留
Ophthalmic Plast Reconstr Surg. 2004 May;20(3):232-6. doi: 10.1097/01.iop.0000129014.94384.e6.
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Orbital foreign body.眼眶异物
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Post-traumatic orbital cellulitis.
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Penetrating orbital injury with wooden foreign body initially diagnosed as an orbital floor blowout fracture.最初被诊断为眶底爆裂骨折的伴有木质异物的穿透性眼眶损伤。
ANZ J Surg. 2002 Jul;72(7):529-30. doi: 10.1046/j.1445-2197.2002.02448.x.
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Orbital foreign body misdiagnosed as superior orbital rim fracture.眼眶异物被误诊为眶上缘骨折。
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Clinical features and management of intraorbital foreign bodies.眶内异物的临床特征与处理
Ophthalmology. 2002 Mar;109(3):494-500. doi: 10.1016/s0161-6420(01)00982-4.
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CT appearances of chronically retained wooden intraorbital foreign bodies.眼眶内长期留存木质异物的CT表现
Neuroradiology. 2001 Feb;43(2):165-8. doi: 10.1007/s002340000458.
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Penetrating orbital injury with organic foreign bodies.伴有有机异物的穿透性眼眶损伤。
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[Swelling in the area of a scar after injury to the orbital wall. Occult foreign body].[眶壁损伤后瘢痕区域肿胀。隐匿性异物]
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