Jamali Omer Mohammed, Al-Sabahi Mohammed Esmail, Shawky Mohamed, Atef Mohammed
Department of Oral and Maxillofacial Surgery, Al-Amal Al Arabi Specialized Hospital, Hodeida, Yemen.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hodeida University, Hodeida, Yemen.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3770-3777. doi: 10.1007/s12070-023-04056-x. Epub 2023 Jul 22.
This study aimed to evaluate the clinical, radiological and functional outcome of early (within 24 h) surgical intervention of displaced orbital roof fractures. This is a prospective observational study for patients with displaced orbital roof fractures. Six patients underwent early surgical management within hours of admission. The primary outcome variables were functional and aesthetic (evaluated through clinical and radiological assessments). The rate of immediate and delayed complications over a 6-months minimum follow-up period was recorded. All patients were males. The median age at the time of presentation was 23.5 years ranging from 4 to 40 years. The etiology was a high impact traffic accident in all patients. In three patients, the orbital roof fractures were unilateral, and in the other three patients, the fractures were bilateral. All patients were treated via transcranial approach at the same time as the neurosurgery. The median follow-up period was 10 months ranging from 6 to 15 months. During the follow-up period, there were no signs of meningitis, cerebrospinal fluid leakage, facial asymmetry, enophthalmos, exophthalmos, restriction of ocular motility, or blindness. Traumatic optic neuropathy was present in two patients (one unilateral and the other bilateral), of whom, one patient achieved full visual acuity recovery, while the other patient showed a mild decrease in visual acuity which improved within 6 months (OD;20/30, OS;20/25). One patient had mild ptosis and recovered spontaneously within 3 months after surgery. Postoperative CT scans showed a good anatomical reconstruction of orbital roof fracture in all cases. Early definite management of displaced orbital roof fractures secures reliable functional and cosmetic results and reduces the incidences of intracranial and ocular complications.
The online version contains supplementary material available at 10.1007/s12070-023-04056-x.
本研究旨在评估移位性眶顶骨折早期（24小时内）手术干预的临床、影像学和功能结局。这是一项针对移位性眶顶骨折患者的前瞻性观察研究。6例患者在入院数小时内接受了早期手术治疗。主要结局变量为功能和美观（通过临床和影像学评估）。记录了至少6个月随访期内的即时和延迟并发症发生率。所有患者均为男性。就诊时的中位年龄为23.5岁，范围为4至40岁。病因均为严重交通事故。3例患者眶顶骨折为单侧，另外3例患者骨折为双侧。所有患者均在神经外科手术的同时通过经颅入路进行治疗。中位随访期为10个月，范围为6至15个月。随访期间，未出现脑膜炎、脑脊液漏、面部不对称、眼球内陷、眼球突出、眼球运动受限或失明的迹象。2例患者出现创伤性视神经病变（1例单侧，1例双侧），其中1例患者视力完全恢复，另1例患者视力轻度下降，6个月内有所改善（右眼；20/30，左眼；20/25）。1例患者有轻度上睑下垂，术后3个月内自发恢复。术后CT扫描显示所有病例眶顶骨折均获得良好的解剖重建。移位性眶顶骨折的早期明确治疗可确保可靠的功能和美容效果，并降低颅内和眼部并发症的发生率。
在线版本包含可在10.1007/s12070-023-04056-x获取的补充材料。
