Kim Junhyung, Park Sang Woo, Choi Jaehoon, Jeong Woonhyeok, Kim Ryeolwoo
Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea.
Department of Plastic and Reconstructive Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
J Plast Reconstr Aesthet Surg. 2018 Apr;71(4):490-495. doi: 10.1016/j.bjps.2017.10.006. Epub 2017 Oct 18.
In this study, details of the infraorbital nerve's (ION's) anatomical course variants were compared using computed tomography (CT), and relationships between the variants and fracture patterns in the orbital floor were investigated. Fifty-two normal individuals and 50 patients with unilateral isolated orbital floor fractures were enrolled in this study. Four measurements in normal individuals and five measurements in fracture patients were obtained in parasagittal sections. The anatomical variations of the ION were categorized into three types according to the classification by Ferences et al. Among the normal individuals, 42 orbits were classified as type 1 ION, 48 orbits as type 2, and 14 orbits as type 3. The distance from the inferior orbital rim to the upper border of the inferior orbital foramen and the length of descension portion of the ION in type 1 ION were significantly shorter than in type 2 and type 3 IONs. In patients with orbital floor fractures, the distance from the inferior orbital rim to the upper border of the inferior orbital foramen was positively correlated with herniation level of bone and soft tissue. The ION had three anatomical variants according to the degree of descension in the anterior portion of the orbit. When fracture of the orbital floor occurs in patients with type 1 ION, inferior displacement of the fractured orbital bone and orbital soft tissue may be less severe than in patients with other ION types.
在本研究中,使用计算机断层扫描(CT)比较眶下神经(ION)解剖走行变异的细节,并研究这些变异与眶底骨折模式之间的关系。本研究纳入了52名正常个体和50名单侧孤立性眶底骨折患者。在矢状旁切面上,对正常个体进行了四项测量,对骨折患者进行了五项测量。根据Ferences等人的分类,ION的解剖变异分为三种类型。在正常个体中,42个眼眶被分类为1型ION,48个眼眶为2型,14个眼眶为3型。1型ION中,眶下缘至眶下孔上缘的距离以及ION下降部分的长度明显短于2型和3型ION。在眶底骨折患者中,眶下缘至眶下孔上缘的距离与骨和软组织的疝出程度呈正相关。根据ION在眼眶前部的下降程度,ION有三种解剖变异。当1型ION患者发生眶底骨折时,骨折的眶骨和眶软组织的下移可能比其他ION类型的患者轻。