Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi, 480-1195, Japan.
Department of Oculoplastic, Orbital & Lacrimal Surgery, Kirtipur Eye Hospital, Kathmandu, Nepal.
Graefes Arch Clin Exp Ophthalmol. 2023 Mar;261(3):841-848. doi: 10.1007/s00417-022-05822-3. Epub 2022 Sep 9.
To examine the relationship between patterns of orbital floor fracture around the infraorbital groove and development of infraorbital nerve hypoesthesia.
This retrospective, observational study included 200 patients (200 sides) of pure orbital floor fracture with or without medial orbital wall fracture. Data on the presence or absence of infraorbital nerve hypoesthesia were collected from medical records. Based on coronal computed tomographic images, patients were classified into 3 groups: a fracture extending medially to (medial group), into (in-groove group), and laterally to the infraorbital groove (lateral group).
Infraorbital nerve hypoesthesia was found in 72 patients (36.0%). A fracture extended into or laterally to the infraorbital groove in 86.2% of patients with infraorbital nerve hypoesthesia, while a fracture was limited to the portion medial to the infraorbital groove in 77.3% of patients without infraorbital nerve hypoesthesia (P < 0.001). A logistic regression analysis demonstrated that patients in the lateral and in-groove groups were highly associated with development of infraorbital nerve hypoesthesia, with an odds ratio of 134.788 in the lateral group (95% confidence interval, 30.496-595.735; P < 0.001) and that of 20.323 in the in-groove group (95% confidence interval, 6.942-59.499; P < 0.001) with the medial group as the reference.
This study indicates that patients with orbital floor fracture extending into or laterally to the infraorbital groove have a high risk of infraorbital nerve hypoesthesia, compared to those with orbital floor fracture limited to the portion medial to the infraorbital groove.
探讨眶下沟周围眶底骨折模式与眶下神经感觉减退的关系。
本回顾性观察性研究纳入了 200 例（200 侧）单纯眶底骨折伴或不伴内侧眶壁骨折患者。从病历中收集眶下神经感觉减退的存在或缺失数据。根据冠状位 CT 图像，患者分为 3 组：骨折向内侧延伸至眶下沟（内侧组）、进入（沟内组）或向眶下沟外侧延伸（外侧组）。
72 例（36.0%）患者出现眶下神经感觉减退。眶下神经感觉减退患者中，骨折向眶下沟内或外侧延伸者占 86.2%，而无眶下神经感觉减退患者中，骨折仅限于眶下沟内侧者占 77.3%（P < 0.001）。Logistic 回归分析显示，外侧组和沟内组患者发生眶下神经感觉减退的风险较高，外侧组的优势比为 134.788（95%置信区间，30.496-595.735；P < 0.001），沟内组的优势比为 20.323（95%置信区间，6.942-59.499；P < 0.001），以内侧组为参照。
与骨折仅限于眶下沟内侧的患者相比，眶底骨折向眶下沟内或外侧延伸的患者发生眶下神经感觉减退的风险更高。
