Breuer T, Grossenbacher R
Hals- und Gesichtschirurgie, HNO-Klinik, Kantonsspital, Rorschacher Str., 9007, St. Gallen, Schweiz.
HNO. 2007 Mar;55(3):211-6. doi: 10.1007/s00106-006-1393-8.
Blindness is the most serious injury to the eye following a midfacial fracture. The onset of blindness complicating the midfacial fracture may be immediate (with the trauma), delayed (hours to days), or postoperative. The incidence of postoperative blindness lies between 0.3 and 8.3%. There are multiple mechanisms responsible for blindness but the most common reason with about 66% is probably increased intraorbital pressure attributable to intraorbital hemorrhage. The management of surgical decompression of the orbit for acute blindness is essential when treatment of a midfacial fracture is intended. Acute orbital compartment syndrome can effectively be relieved by lateral canthotomy and cantholysis and administration of high doses of corticosteroids. Further possibilities of surgical decompression of the orbit are discussed in this case report with postoperative irreversible blindness after reduction of a malar fracture and rapidly performed surgical decompression.
失明是面中部骨折后最严重的眼部损伤。面中部骨折并发失明的情况可能是即时性的（与外伤同时发生）、延迟性的（数小时至数天）或术后发生的。术后失明的发生率在0.3%至8.3%之间。导致失明的机制有多种，但最常见的原因（约占66%）可能是眶内出血导致眶内压力升高。当打算对面中部骨折进行治疗时，对于急性失明进行眼眶手术减压至关重要。急性眶隔综合征可通过外眦切开术、眦松解术以及给予大剂量皮质类固醇得到有效缓解。本病例报告讨论了在颧骨骨折复位后出现术后不可逆失明并迅速进行手术减压的情况下，眼眶手术减压的其他可能性。
