Deichmüller Cordula M C, Welkoborsky H-J
Klinik für Hals-Nasen-Ohrenheilkunde, Kopf-Hals-Tumorzentrum, Klinikum Region Hannover GmbH, Klinikum Nordstadt, Haltenhoffstraße 41, 30167, Hannover, Deutschland.
HNO. 2018 Oct;66(10):721-729. doi: 10.1007/s00106-018-0525-2.
In the case of trauma to the midface, an accompanying fracture of the orbit is common because to the anatomical conditions (bony buttresses of the midface). Etiology varies according to locoregional conditions.
An overview of orbital traumatology including diagnostic procedures, symptoms and therapy is provided. In addition, our own patient collective over one year including a 5-year follow-up was prospectively analyzed.
The possible fractures of the midface with involvement of the orbit including their classifications are listed. The key clinical symptoms and the diagnostic procedure are described. As part of the therapeutic management, in addition to the-mostly required-surgical approach, the conservative therapeutic options and prerequisites for conservative therapy are discussed. In our own patients, clear differences in the accident mechanisms were evident. Violence was the most frequent mechanism for younger, male patients, while in female, elderly patients a fall was the reason for the fracture. Overall, 17% of cases received conservative therapy and 83% underwent surgical treatment.
Traumatology of the orbit requires that therapeutic decisions be made on an individual patient basis. Even a conservative regime can lead to good results. The treatment of fractures of the orbit and the midface should be in the hands of experienced midface surgeons due to the technical competence with regard to the anatomy of the neighboring structures.
在中面部创伤的情况下,由于解剖学条件(中面部的骨性支柱),眼眶伴发骨折很常见。病因因局部情况而异。
提供了眼眶创伤学的概述,包括诊断程序、症状和治疗方法。此外,对我们自己一年来的患者群体进行了前瞻性分析,包括5年随访。
列出了累及眼眶的中面部可能骨折及其分类。描述了关键临床症状和诊断程序。作为治疗管理的一部分,除了大多需要的手术方法外,还讨论了保守治疗选择和保守治疗的前提条件。在我们自己的患者中,事故机制存在明显差异。暴力是年轻男性患者最常见的机制,而在女性、老年患者中,跌倒则是骨折的原因。总体而言,17%的病例接受了保守治疗,83%接受了手术治疗。
眼眶创伤学要求根据个体患者情况做出治疗决策。即使是保守治疗方案也能取得良好效果。由于对邻近结构解剖学的技术能力,眼眶和中面部骨折的治疗应由经验丰富的中面部外科医生进行。