Chan Patrick, Graue Gerardo F, Pizzarello Daniel B, Kim Alyn J, Kazim Michael
Department of Ophthalmology, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA.
Orbit. 2013 Feb;32(1):27-9. doi: 10.3109/01676830.2012.747215.
To evaluate the influence of saline irrigation on temperature rise in orbit bones and the optic canal during high-speed drilling.
An experimental study measuring temperature rise in an orbit during high-speed drilling was conducted. The orbital rims, sphenoid bone, and optic canals of 6 unpreserved caprine orbits were drilled with a 3.1-mm diamond drill bit at 35,000 rpm. Each orbit was divided into groups receiving no irrigation, continuous or intermittent external irrigation at 5-second intervals during the procedures. The temperature rise of each site was compared among the groups, along with the duration of drilling.
The mean (± SD) temperature elevation in the optic canal without irrigation was 2.38 °C (± 0.30 °C). This was significantly higher than in the canals receiving intermittent irrigation (0.90 °C ± 0.40 °C; p < 0.001) and continuous irrigation (0.66 °C ± 0.40 °C; p < 0.001). Mean temperature rise in the orbital rim without irrigation was significantly higher (3.51 °C ± 1.30 °C) than with intermittent (1.05 °C ± 0.31 °C; p < 0.001) and continuous (0.98 °C ± 0.61 °C; p < 0.001) irrigation. Mean temperature rise in the sphenoid was significantly higher (3.68 °C ± 1.66 °C) without irrigation than with intermittent (1.36 °C ± 1.17 °C; p = 0.005) and continuous (0.90 °C ± 0.33 °C; p < 0.001) irrigation. There were no statistically significant differences between any of the intermittent and continuous irrigation groups.
The presence of either continuous or intermittent irrigation during orbital drilling procedures significantly decreases the temperature rise in the region adjacent to the surgical site. This has important implications for surgical technique when operating near the optic canal. Further studies regarding potential effects on the optic nerve are warranted.
评估生理盐水冲洗对高速钻孔过程中眼眶骨和视神经管温度升高的影响。
进行了一项测量高速钻孔过程中眼眶温度升高的实验研究。使用3.1毫米金刚石钻头以35000转/分钟的转速对6个未保存的山羊眼眶的眶缘、蝶骨和视神经管进行钻孔。每个眼眶被分为不冲洗组、在手术过程中以5秒间隔进行连续或间歇性外部冲洗组。比较各组中每个部位的温度升高情况以及钻孔持续时间。
未冲洗时视神经管的平均（±标准差）温度升高为2.38℃（±0.30℃）。这显著高于接受间歇性冲洗（0.90℃±0.40℃；p<0.001）和连续冲洗（0.66℃±0.40℃；p<0.001）的神经管。未冲洗时眶缘的平均温度升高（3.51℃±1.30℃）显著高于间歇性冲洗（1.05℃±0.31℃；p<0.001）和连续冲洗（0.98℃±0.61℃；p<0.001）。未冲洗时蝶骨的平均温度升高（3.68℃±1.66℃）显著高于间歇性冲洗（1.36℃±1.17℃；p = 0.005）和连续冲洗（0.90℃±0.33℃；p<0.001）。任何间歇性冲洗组和连续冲洗组之间均无统计学显著差异。
眼眶钻孔手术过程中连续或间歇性冲洗的存在显著降低了手术部位附近区域的温度升高。这对于在视神经管附近进行手术时的手术技术具有重要意义。有必要进一步研究其对视神经的潜在影响。
