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[眼眶减压术:适应症、技术、结果]

[Orbital decompression : Indications, technique, results].

作者信息

Welkoborsky H-J, Graß S K, Küstermeyer J, Steinke K V

机构信息

Klinik für HNO-Heilkunde, Kopf- und Halschirurgie, region. Plast. Chirurgie, Klinikum Nordstadt der KRH, Hannover, Haltenhoffstr. 41, 30167, Hannover, Deutschland.

出版信息

HNO. 2017 Dec;65(12):1023-1038. doi: 10.1007/s00106-017-0429-6.

Abstract

Orbital decompression is an effective surgical procedure to reduce intraorbital pressure. Causes may diseases leading to rapid pressure increases, e. g., bleedings, and those causing slower, progressive pressure increases, e. g., tumors or Graves' orbitopathy. During fat tissue decompression, peri- and retrobulbar adipose tissue is removed; in bony decompression, one or more bony orbital walls are removed (one-, two-, or three-wall decompression). In many cases the procedures are combined. Recent developments are the transconjunctival approaches for removing parts of bony orbital walls. Complications include double vision, which occurs in up to 30% of cases depending on the approach, hemorrhage, infections, development of chronic sinusitis, and iatrogenic skull base lesions with consecutive meningitis. In the hands of an experienced rhino- and head and neck surgeon, the intervention has low complication rates.

摘要

眼眶减压术是一种降低眶内压力的有效外科手术。病因可能是导致压力迅速升高的疾病,如出血,以及引起压力缓慢、渐进性升高的疾病,如肿瘤或格雷夫斯眼眶病。在脂肪组织减压过程中,去除眶周和球后脂肪组织;在骨性减压中,去除一个或多个眶壁(单壁、双壁或三壁减压)。在许多情况下,这些手术会联合进行。最近的进展是经结膜入路去除部分眶壁。并发症包括复视,根据手术入路不同,发生率高达30%,还有出血、感染、慢性鼻窦炎的发生以及医源性颅底病变并继发脑膜炎。在经验丰富的鼻科和头颈外科医生手中,该手术的并发症发生率较低。

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