Boush G A, Lemke B N
Department of Ophthalmology and Visual Sciences, University of Wisconsin Hospital and Clinics, Madison 53792-3220.
Ophthalmic Plast Reconstr Surg. 1994 Dec;10(4):271-5. doi: 10.1097/00002341-199412000-00010.
Traumatic blow-out fractures of the orbital floor are a common injury that can lead to significant morbidity. Accepted indications for surgical repair include displaced fractures consisting of a defect > 50% of the orbital floor, extraocular muscle entrapment, and clinically significant enophthalmos. Although infraorbital nerve hypesthesia has been reported as an indication for repair of fractures of the zygomatic complex and is often encountered as an associated finding in fractures of both the orbital floor and inferior orbital rim, it has not been generally regarded as a primary indication for blow-out fracture repair. We report two patients in whom severe, progressive infraorbital nerve hypesthesia served as the primary indication for surgical repair. Both patients experienced improvement in infraorbital nerve function following surgical repair, accompanied by persistent pain and paresthesias in the distribution of the infraorbital nerve. We suggest that progressive infraorbital nerve hypesthesia should be considered a primary indication for blow-out fracture repair in selected patients in whom hypesthesia is both severe and progressive.
眼眶底的外伤性爆裂骨折是一种常见损伤，可导致明显的发病情况。手术修复的公认指征包括移位骨折，即眼眶底缺损超过50%、眼外肌嵌顿以及临床上明显的眼球内陷。虽然眶下神经感觉减退已被报道为颧骨复合体骨折修复的指征，并且在眼眶底和眶下缘骨折中经常作为相关发现出现，但它一般未被视为爆裂骨折修复的主要指征。我们报告了两名患者，其中严重、进行性眶下神经感觉减退是手术修复的主要指征。两名患者在手术修复后眶下神经功能均有改善，但眶下神经分布区域仍持续存在疼痛和感觉异常。我们建议，对于感觉减退严重且呈进行性的特定患者，进行性眶下神经感觉减退应被视为爆裂骨折修复的主要指征。
