Banerjee Rajarshi, Basu Subhransu, Pachisia Sandeep, Sahu Sudipto, Mishra Mayukh, Ghosh Sucharu
Department of Oral and Maxillofacial Surgery, Haldia Institute of Dental Sciences and Research, West Bengal University of Health Sciences, Haldia, West Bengal India.
Indian J Otolaryngol Head Neck Surg. 2019 Jun;71(2):225-232. doi: 10.1007/s12070-018-1473-6. Epub 2018 Sep 4.
The nasoorbitoethmoidal fractures remain the most complex of all facial fractures to diagnose and treat mainly because of the intricate anatomy and difficulty in fracture fixation. The number of such fractures are increasing with the more incidence of high-speed, high-force accidents. The nasoorbitoethmoidal fractures rarely occur as an isolated event. Associated injuries often include central nervous system injuries, cribriform plate fracture, cerebrospinal fluid rhinorrhea, and fractures of the frontal bone, orbital floor, and middle third of the face as well as injury to the lacrimal system. The appropriate management of these injuries require an understanding of the anatomic features of the region, the degree of severity of damage. The purpose of this article is to provide a general overview of the topic, with a more specific focus on the pearls of managing these fractures. Twenty-four patients who suffered The nasoorbitoethmoidal fractures with/without associated multiple midfacial injuries were included in the study. Postoperatively, results show stable symmetrical fixation of the canthus in three dimensions with good apposition of the eyelids against the ocular globe along with acceptable nasofrontal angle and nasal prominence. Prompt and proper management of these injuries can achieve both adequate functional and aesthetic outcomes.
鼻眶筛骨折仍然是所有面部骨折中诊断和治疗最为复杂的,主要原因在于其解剖结构复杂以及骨折固定困难。随着高速、高暴力事故发生率的增加,此类骨折的数量也在上升。鼻眶筛骨折很少单独发生。相关损伤通常包括中枢神经系统损伤、筛板骨折、脑脊液鼻漏、额骨、眶底和面部中三分之一骨折以及泪器损伤。对这些损伤进行恰当处理需要了解该区域的解剖特征和损伤的严重程度。本文旨在对该主题进行总体概述,更具体地聚焦于处理这些骨折的要点。本研究纳入了24例伴有或不伴有面部多处合并伤的鼻眶筛骨折患者。术后结果显示,内眦在三维空间内固定稳定且对称,眼睑与眼球贴合良好,鼻额角和鼻突度可接受。对这些损伤进行及时、恰当的处理能够实现良好的功能和美学效果。