Alinasab Babak, Beckman Mats O, Pansell Tony, Abdi Saber, Westermark Anders H, Stjärne Pär
Division of Otorhinolaryngology, Department of Clinical Sciences, Intervention and Technology, Solna.
Craniomaxillofac Trauma Reconstr. 2011 Dec;4(4):203-12. doi: 10.1055/s-0031-1286117.
In orbital floor fractures, the estimation of the herniated orbital content in the maxillary sinus has traditionally been the dividing line between surgical and nonsurgical management. In this study, we evaluated whether a relative change in volume would function as an indicator for surgical versus nonsurgical treatment of orbital floor fractures. This was a follow-up study in patients with untreated unilateral isolated orbital floor fractures admitted to our department from March 2003 to April 2007. Patients were contacted by regular mail and invited to have a clinical eye examination. The volume of the orbital content was calculated digitally from the patients' computed tomography scans at the time of their injury. Eighteen subjects with no facial skeleton fracture were included for reference of orbital content volumes. Five of 23 patients showed 2 to 4 mm of enophthalmos, and only three of them had intermittent diplopia. No statistical correlation was found between the herniated volume and enophthalmos. No statistical correlation supporting the supposition that 1 mL of herniated orbital content would result in 1 mm of enophthalmos was found. The relative volume change between the fractured and nonfractured orbit in an individual does not appear to be a useful criterion for surgery. The importance of the herniated orbital tissue for the development of enophthalmos is unclear.
在眶底骨折中，对上颌窦内疝入的眶内容物进行评估，传统上一直是手术治疗与非手术治疗的分界线。在本研究中，我们评估了体积的相对变化是否可作为眶底骨折手术治疗与非手术治疗的一个指标。这是一项对2003年3月至2007年4月间收治于我科的未经治疗的单侧孤立性眶底骨折患者的随访研究。通过定期邮寄与患者取得联系，并邀请他们进行临床眼部检查。眶内容物的体积在患者受伤时通过计算机断层扫描进行数字化计算。纳入18例无面部骨骼骨折的受试者作为眶内容物体积的对照。23例患者中有5例出现2至4毫米的眼球内陷，其中只有3例有间歇性复视。未发现疝入体积与眼球内陷之间存在统计学相关性。未发现支持眶内容物疝入1毫升会导致1毫米眼球内陷这一假设的统计学相关性。个体骨折眼眶与未骨折眼眶之间的相对体积变化似乎并非手术的有用标准。疝入的眶组织对眼球内陷发展的重要性尚不清楚。
