Sandner A, Kösling S, Heider C, Bloching M B
Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie der Martin-Luther-Universität Halle-Wittenberg, Halle/Saale.
HNO. 2007 Jun;55(6):481-4. doi: 10.1007/s00106-006-1406-7.
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.
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。