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作为因颈内动脉发育不全导致的勒福Ⅰ型截骨术并发症的失明和基底节缺氧:一例报告

Blindness and basal ganglia hypoxia as a complication of Le Fort I osteotomy attributable to hypoplasia of the internal carotid artery: a case report.

作者信息

Cheng Hsin-Chung, Chi Li-Hsing, Wu Jia-Yo, Hsieh Tseng-Ting, Pemg Bo-Yue

机构信息

Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Jul;104(1):e27-33. doi: 10.1016/j.tripleo.2007.01.016. Epub 2007 May 11.

Abstract

Le Fort I osteotomy is used as a surgical procedure for correction of maxillofacial deformities. The common complications of this procedure are hemorrhage and infection, with incidence of 6% to 9%. Blindness associated with Le Fort I osteotomy was reported in 8 patients. An 18-year-old female complained of loss of sight in the left eye after recovery from hypotensive general anesthesia. The visual field of the left eye was dark and only perceived some movement. She presented with motor dysfunction and regressive behavior 2 weeks later as a result of hypoxia of bilateral basal ganglia. Two months later, her visual acuity recovered gradually and regressive behavior improved. Carotid angiography showed congenital hypoplasia of the left internal carotid artery. We suspected that hypoplasia could cause hypoxia of the central nervous system.

摘要

勒福Ⅰ型截骨术用作矫正颌面畸形的外科手术。该手术的常见并发症是出血和感染,发生率为6%至9%。有8例患者报告了与勒福Ⅰ型截骨术相关的失明。一名18岁女性在从低血压全身麻醉恢复后,主诉左眼失明。左眼视野黑暗,仅能感知一些运动。两周后,由于双侧基底节缺氧,她出现了运动功能障碍和退行性行为。两个月后,她的视力逐渐恢复,退行性行为有所改善。颈动脉血管造影显示左侧颈内动脉先天性发育不全。我们怀疑发育不全可能导致中枢神经系统缺氧。

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