Cesk Slov Oftalmol. 2021 Winter;77(1):45-48. doi: 10.31348/2021/5.
Orbital fractures may be accompanied with severe damage of the eye bulb and other intraorbital tissues. Early clinical findings can be very mild, therefore it is vital to actively seek not only for any damage done to the soft tissues of the orbit, but also for extraorbital complications such as liquorrhea or meningitis. We report a relatively rare case of blow-in fracture of orbital roof in eleven years old boy. Patient was admitted to the emergency care after falling off a bicycle without impaired consciousness. During admission ophthalmologist evaluated the condition as severe contusion of the left bulb, with hemophthalmia and retinal comotosis. Due to significant swelling of eye lids and periorbital hematoma, it was not possible to perform specific tests to objectify possible oculomotor disorder and diplopia. CT scan findings show dislocated fracture of orbital roof with fragments reaching into the musculus rectus superior. For high risk of bulbus penetration and muscle damage a surgical intervention with bone fragments removal was performed using endoscopic assisted frontal orbitotomy. After operation patient had no signs of functional eye disorder.
眼眶骨折可能伴有眼球和其他眶内组织的严重损伤。早期临床发现可能非常轻微,因此积极寻找不仅是眶内软组织的任何损伤,还要寻找眼球外并发症,如脑脊液漏或脑膜炎至关重要。我们报告了一例 11 岁男孩罕见的眶顶爆裂性骨折病例。患者从自行车上摔下后无意识丧失,被送往急诊室。入院时,眼科医生评估病情为左眼严重挫伤,伴有眼内出血和视网膜震荡。由于眼睑明显肿胀和眶周血肿,无法进行特定检查以客观评估可能的眼动障碍和复视。CT 扫描结果显示眶顶有错位骨折,碎片进入上直肌。由于眼球穿透和肌肉损伤的高风险,采用内镜辅助额眶切开术进行了骨碎片切除的手术干预。手术后,患者没有出现功能障碍的迹象。