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拔牙后急性球后出血:一种罕见疾病的病例报告和治疗。

Acute retrobulbar hemorrhage after tooth extraction: Case report and treatment of a rare condition.

机构信息

Georgetown University, Washington, District of Columbia, USA.

TOC Eye and Face, Austin, Texas, USA.

出版信息

Spec Care Dentist. 2022 May;42(3):304-307. doi: 10.1111/scd.12673. Epub 2021 Nov 4.

Abstract

Retrobulbar hemorrhage (RBH) refers to hemorrhage within the bony orbital cavity and most commonly results from periorbital surgery or trauma. RBH following tooth extraction is a rare occurrence. Patients with RBH will endorse symptoms of periorbital pain, double vision, or vision loss, and present with evidence of proptosis, chemosis, or subconjunctival hemorrhage. Irreversible vision loss may occur if orbital compartment syndrome (OCS) results in the setting of RBH and is not expediently treated. Herein we present a case of a 72-year-old female who developed a RBH and OCS immediately after routine molar tooth extraction. Emergent treatment by the oral surgeon with a lateral canthotomy and inferior cantholysis led to full visual recovery. Dentists and oral surgeons should be aware of this potential rare vision-threatening complication of atraumatic tooth extraction and educated on the technique of decompressive lateral canthotomy and cantholysis.

摘要

球后血肿(RBH)是指眼眶骨腔内的出血,最常见于眶周手术或外伤后。拔牙后发生 RBH 较为罕见。RBH 患者会出现眶周疼痛、复视或视力丧失,并伴有眼球突出、球结膜水肿或结膜下出血。如果 RBH 导致眶隔综合征(OCS),且未能及时治疗,可能会导致不可逆转的视力丧失。本文介绍了一例 72 岁女性患者,在常规磨牙拔牙后立即发生 RBH 和 OCS。口腔外科医生行外侧眦切开和下眦切开紧急治疗后,视力完全恢复。牙医和口腔外科医生应该意识到这种潜在的、无创伤性拔牙导致的严重视力威胁并发症,并接受减压外侧眦切开和眦切开术的技术培训。

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