Lin Ting-Ting, He Yan-Jin, Zhu Li-Min, Zhang Hong, Wang Dong, Song Guo-Xiang
Tianjin Medical University Eye Center, Tianjin 300070, China.
Zhonghua Yi Xue Za Zhi. 2009 Jul 7;89(25):1774-8.
To present some instruction in diagnosis and treatment of the orbital fistula by analyze the clinical manifestation.
The clinical data for 37 cases with orbital fistula treated during 1980 to 2007 were analyzed retrospectively.
Among 37 cases with orbital fistula, there are 21 cases caused by foreign bodies, including 17 cases by retained wooden bodies, 3 cases by iatrogenic foreign bodies and 1 case by firecrackers. There are 9 cases caused by orbital cysts, including 5 cases dermoid cysts, 3 cases epidermoid cysts and 1 case frontal mucopyocele. There are 6 cases orbital infection inflammation, including 5 cases osteomyelitis and 1 case orbital abscess. There is 1 case eosinophilic granuloma. Different etiologies have characteristic features. Medical history, fistula examinations and imaging examinations must be analyzed synthetically in order to make proper etiological diagnosis. Eradicate etiologies and resect fistula are most important. It is necessary to make an ancillary therapy, such as ENT treatment.
The common etiologies of orbital fistula are retained foreign body, dermoid cysts and osteomyelitis. The pathogenesis include infective inflammation, congenital heteroplasia, operation and tumor. B-scan ultrasonography, CT, and MRI can be used for the localization and qualitation diagnosis. There are comprehensive approaches for diagnosis and management of this type of injury. In order to give an effective therapy, we must make an accurate diagnosis and analyze the features of fistula.
通过分析眼眶瘘的临床表现,提供一些诊断和治疗指导。
回顾性分析1980年至2007年期间治疗的37例眼眶瘘患者的临床资料。
37例眼眶瘘患者中,21例由异物引起,其中17例为残留木质异物,3例为医源性异物,1例为鞭炮伤。9例由眼眶囊肿引起,其中5例为皮样囊肿,3例为表皮样囊肿,1例为额窦黏液囊肿。6例为眼眶感染性炎症,其中5例为骨髓炎,1例为眼眶脓肿。1例为嗜酸性肉芽肿。不同病因有其特征性表现。必须综合分析病史、瘘管检查和影像学检查,以做出正确的病因诊断。根除病因和切除瘘管最为重要。有必要进行辅助治疗,如耳鼻喉科治疗。
眼眶瘘的常见病因是异物残留、皮样囊肿和骨髓炎。发病机制包括感染性炎症、先天性发育异常、手术和肿瘤。B超、CT和MRI可用于定位和定性诊断。对于这类损伤有综合的诊断和处理方法。为了进行有效的治疗,必须做出准确的诊断并分析瘘管的特征。