Thiesmann R, Erfeld T, Hesse G, Laubert A, Meyer-Rüsenberg H-W
Augenklinik, St.-Josefs-Hospital, Kath. Krankenhaus Hagen gem. GmbH, Augenklinik der Universität Witten-Herdecke.
Klin Monbl Augenheilkd. 2009 Jul;226(7):555-60. doi: 10.1055/s-0028-1109508. Epub 2009 Jul 30.
Orbital and periorbital complications due to acute paranasal sinusitis can be treated surgically or conservatively. In many cases the type of treatment depends on the ophthalmological findings. In the context of this clinical analysis we explored whether a conservative rather than an surgical therapy should be chosen for specific otorhinolaryngological or ophthalmological findings.
32 patients were treated conservatively, whereas 4 patients had to be operated. Before therapy and after completion of the treatment otorhinolaryngologistical and ophthalmological findings were recorded and these findings as well as the two therapy options were compared with each other.
In the cases of the 32 conservatively treated patients plus the 4 patients, who were treated surgically, a complete restitutio ad integrum could be observed at the end of the treatment period.
A conservative therapy is obsolete in cases with specific ophthalmological findings such as reduction of vision, significant increase of exophthalmos, extreme limitation of motility. In all other cases, a conservative attempt can be made first, because the results of this therapy are as good as the results of surgical intervention but with less exposure for the patient. So the choice of therapy depends the ophthalmological findings.
急性鼻窦炎引起的眼眶及眶周并发症可通过手术或保守治疗。在许多情况下,治疗方式取决于眼科检查结果。在本次临床分析中,我们探讨了针对特定的耳鼻喉科或眼科检查结果,是否应选择保守治疗而非手术治疗。
32例患者接受了保守治疗,而4例患者不得不接受手术治疗。在治疗前及治疗结束后,记录耳鼻喉科和眼科检查结果,并将这些结果以及两种治疗方案相互比较。
在32例接受保守治疗的患者以及4例接受手术治疗的患者中,在治疗期结束时均可观察到完全康复。
对于出现如视力下降、眼球突出明显增加、活动严重受限等特定眼科检查结果的病例,保守治疗已过时。在所有其他情况下,可首先尝试保守治疗,因为该治疗结果与手术干预的结果一样好,但对患者的创伤较小。因此,治疗方式的选择取决于眼科检查结果。