Tomasetti Patrick, Jacbosen Christine, Gander Thomas, Zemann Wolfgang
Department of Cranio-Maxillofacial and Oral Surgery, University Hospital Zürich,Zürich, Switzerland
Department of Cranio-Maxillofacial and Oral Surgery, University Hospital Zürich,Zürich, Switzerland.
J Surg Case Rep. 2013 Mar 21;2013(3):rjt011. doi: 10.1093/jscr/rjt011.
Orbital floor fractures are generally the result of blowout orbital and may be associated with orbital emphysema leading to proptosis and even to loss of vision. A 49-year-old woman fractured the orbital floor in a fall. After blowing her nose, she developed exophthalmos and severe reduction in vision. She consulted our department and underwent emergency surgical management with orbital drainage. Decompression led to immediate resolution of the exophthalmos and postoperative improvement in visual acuity. Urgent decompression is indicated by the presence of proptosis, elevated intraocular pressure, and progressive loss of vision in cases of orbital trauma with additional emphysema. Surgical treatment of tension emphysema includes lateral canthotomy or cantholysis, needle aspiration, transconjunctival, or lateral blepharoplasty approach, and bone decompression depending on the severity of the case. Sneezing or blowing the nose can lead to proptosis and decreased visual acuity secondary to trauma to the orbit. Under such circumstances, emergency decompression is essential.
眶底骨折通常是眶爆裂伤的结果，可能伴有眶气肿，导致眼球突出甚至视力丧失。一名49岁女性在跌倒时造成眶底骨折。擤鼻后，她出现眼球突出和视力严重下降。她前来我科就诊并接受了眼眶引流的紧急手术治疗。减压后眼球突出立即缓解，术后视力改善。对于伴有额外气肿的眼眶创伤病例，若出现眼球突出、眼压升高和视力进行性丧失，则需紧急减压。张力性气肿的手术治疗包括外眦切开术或眦松解术、针吸、经结膜或外侧睑成形术入路，以及根据病情严重程度进行骨减压。打喷嚏或擤鼻可导致眶外伤后继发眼球突出和视力下降。在这种情况下，紧急减压至关重要。
