Gray L N, Kalimuthu R, Jayaram B, Lewis N, Sohaey M
Br J Plast Surg. 1985 Jan;38(1):113-5. doi: 10.1016/0007-1226(85)90097-9.
The Cook County Hospital, Chicago, Illinois, protocol for the management of orbital fractures is presented. Diplopia which fails to resolve in 1 week or appears after oedema subsides, enophthalmos or radiographic depression of the orbital floor, associated tripod fracture deformity, or purulent maxillary sinusitis are indications for surgery. The surgical procedure is a modification of the maxillary sinus approach, which includes the use of iodoform gauze packing, nasal antrostomy, a double layer oral closure and prophylactic antibiotics. A review of 102 patients treated surgically over a 6-year period is presented. Post-operative diplopia was 9% and there were minor complications in 3%, which were significantly lower than previously reported series of orbital fractures treated either non-operatively, or through an orbital exploration approach. No patient treated non-operatively required surgery in the future. The protocol presented can eliminate unnecessary exploration and yields excellent results with a simple surgical procedure.
介绍了伊利诺伊州芝加哥库克县医院眼眶骨折的处理方案。复视在1周内未缓解或在水肿消退后出现、眼球内陷或眶底影像学凹陷、伴有三脚架骨折畸形或化脓性上颌窦炎均为手术指征。手术方法是对上颌窦入路的改良，包括使用碘仿纱条填塞、鼻上颌窦造口术、双层口腔闭合和预防性使用抗生素。本文回顾了6年间接受手术治疗的102例患者。术后复视发生率为9%，轻微并发症发生率为3%，显著低于以往报道的非手术治疗或经眼眶探查入路治疗的眼眶骨折系列。非手术治疗的患者未来均无需再次手术。所介绍的方案可避免不必要的探查，并通过简单的手术程序取得优异的效果。
