Ha Austin Y, Mangham William, Frommer Sarah A, Choi David, Klinge Petra, Taylor Helena O, Oyelese Adetokunbo A, Sullivan Stephen R
Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Craniomaxillofac Trauma Reconstr. 2017 Mar;10(1):11-15. doi: 10.1055/s-0036-1584395. Epub 2016 Sep 15.
Traumatic orbital roof fractures are rare and are managed nonoperatively in most cases. They are typically associated with severe mechanisms of injury and may be associated with significant neurologic or ophthalmologic compromise including traumatic brain injury and vision loss. Rarely, traumatic encephalocele or pulsatile exophthalmos may be present at the time of injury or develop in delayed fashion, necessitating close observation of these patients. In this article, we describe two patients with minimally displaced blow-in type orbital roof fractures that were later complicated by orbital encephalocele and pulsatile exophthalmos, prompting urgent surgical intervention. We also suggest a management algorithm for adult patients with orbital roof fractures, emphasizing careful observation and interdisciplinary management involving plastic surgery, neurosurgery, and ophthalmology.
创伤性眶顶骨折较为罕见，多数情况下采用非手术治疗。它们通常与严重的损伤机制相关，可能伴有严重的神经或眼科损害，包括创伤性脑损伤和视力丧失。极少数情况下，创伤性脑膨出或搏动性眼球突出可能在受伤时出现，或延迟发生，因此需要对这些患者进行密切观察。在本文中，我们描述了两名患有轻度移位的 blow-in 型眶顶骨折的患者，这些骨折后来并发了眶脑膨出和搏动性眼球突出，从而促使进行紧急手术干预。我们还提出了一种针对成年眶顶骨折患者的管理算法，强调仔细观察以及涉及整形手术、神经外科和眼科的多学科管理。
