Scarfo G B, Mariottini A, Palma L
Divisione di Neurochirurgia, Università di Siena, Italy.
J Neurosurg Sci. 1990 Apr-Jun;34(2):111-6.
Two unusual cases of perforating oculocerebral trauma by foreign bodies treated surgically are reported. Both were caused by industrial accidents. In the first a nail shot from a nail gun ricocheted off the target and crossed the right eyeball and the posterior wall of the orbit, lodging in the homolateral temporal lobe. In the second case a metal fragment expelled by an agricultural machine penetrated the left maxillary sinus, crossed the floor of the orbit, the eyeball and the roof of the orbit and lodged in the homolateral frontal lobe. After accurate neuroradiological examination the patients were operated using simultaneous transcranial and transorbital access. In our opinion this is the only approach which can minimize the risk of infection which is so dangerous in this type of trauma. The functional and aesthetic results, which were very satisfactory in both cases, seem to confirm the correctness of this approach.
本文报告了两例通过手术治疗的异物所致的罕见穿通性眼脑外伤病例。两例均由工业事故引起。第一例中，射钉枪射出的钉子从目标物上反弹，穿过右眼眼球和眶后壁，嵌顿于同侧颞叶。第二例中，农业机械抛出的金属碎片穿透左上颌窦，穿过眶底、眼球和眶顶，嵌顿于同侧额叶。经过精确的神经放射学检查后，对患者采用经颅和经眶联合入路进行手术。我们认为，这是唯一一种能够将此类创伤中极具危险性的感染风险降至最低的方法。两例患者的功能和美学效果均非常令人满意，似乎证实了这种手术方法的正确性。
