Markakis E, Kolenda H, Behnke J, Mühlendyck H
Neurochirurgische Klinik, Universität Göttingen.
Neurochirurgia (Stuttg). 1990 May;33(3):73-7. doi: 10.1055/s-2008-1053559.
A modified frontobasal osteoplastic orbitotomy with reconstruction of the orbital roof for operative approach to intraorbital processes of any localization and of different origin (tumors, foreign bodies etc.) will be presented. After a small trapezium-shaped frontal craniotomy, the superior orbital rim and the orbital roof are resected in one piece by means of an oscillating saw. This "orbital flap" has a triangular shape, its long tip pointing to the canal of the optic nerve. There is no significant retraction of the frontal lobe by using microscope. The orbital flap is replaced and fixed by two miniplates of Luhr. This technique facilitates a significantly better exposure of all intraorbital structures than other surgical approaches, reduces operative trauma, and has better postoperative functional results. In the last 4 years we have operated upon 16 cases by means of this method, which will be presented. Although in many cases the frontal sinus was involved there was only one infection. Most common postoperative complication (50%) has been lesion of the levator palpebrae muscle followed by ptosis, which usually improved after 4-6 weeks.
本文将介绍一种改良的额底部骨成形眶切开术，该术式通过重建眶顶来处理眼眶内任何部位、不同来源的病变（肿瘤、异物等）。在进行一个小的梯形额部开颅术后，使用摆动锯将眶上缘和眶顶整块切除。这个“眶瓣”呈三角形，其长尖指向视神经管。使用显微镜时额叶不会有明显的牵拉。眶瓣用两个鲁尔微型钢板复位并固定。与其他手术入路相比，该技术能显著更好地暴露所有眶内结构，减少手术创伤，术后功能效果更佳。在过去4年里，我们用这种方法为16例患者进行了手术，本文将予以展示。尽管在许多病例中额窦受累，但仅发生了1例感染。最常见的术后并发症（50%）是提上睑肌损伤伴上睑下垂，通常在4至6周后有所改善。
