Lascaratos Gerassimos, McHugh James, McCarthy Karon, Bunting Howard
a West Kent Eye Centre , Princess Royal University Hospital, Farnborough Common , Orpington , Kent , United Kingdom.
Orbit. 2016 Jun;35(3):164-6. doi: 10.3109/01676830.2016.1139594. Epub 2016 Mar 24.
We report a case of bilateral infero-medial orbital wall destruction, associated with loss of sinonasal architecture. The patient presented with intermittent horizontal diplopia following an acute on chronic infective sinusitis. Eight months previously the patient had developed a midline hard palate fistula for which a palatine prosthesis had been fitted. The broad differential diagnosis is discussed, though in this patient chronic cocaine abuse was identified as the underlying aetiology. Eye movement restriction worsened progressively with bilateral inflammation around the medial and inferior rectus muscles. Attempts to resolve the recurring cycle of sinus infection and inflammation by palatal fistula closure failed despite augmented techniques mobilising flaps from both nasal and palatal sides.
我们报告一例双侧眶内下壁破坏病例，伴有鼻窦结构丧失。该患者在慢性感染性鼻窦炎急性发作后出现间歇性水平复视。8个月前，患者出现中线硬腭瘘，并已安装腭部假体。文中讨论了广泛的鉴别诊断，不过在该患者中，慢性可卡因滥用被确定为潜在病因。随着双侧内直肌和下直肌周围炎症的出现，眼球运动受限逐渐加重。尽管采用了从鼻腔和腭部两侧动员皮瓣的增强技术，但试图通过关闭腭瘘来解决鼻窦感染和炎症的反复循环的尝试仍告失败。
