Carls F R, Schuknecht B, Sailer H F
Klinik und Poliklinik für Kiefer- und Gesichtschirurgie, Zürich.
Fortschr Kiefer Gesichtschir. 1994;39:23-7.
Before reconstruction of the orbital walls and other surgical procedures concerning the orbits leading to a modification of pathologically altered orbital volumes, it is useful to measure these volumes in order to allow preciser correction. Orbital volumetric studies on 22 patients and 6 dry skulls were performed using high resolution computer tomography. 14 patients presented enophthalmos of various origin, 3 patients fibrous dysplasia involving the orbits and 5 patients showed no orbital pathology. In 10 patients with unilateral posttraumatic enophthalmos an increase of the bony orbital volume of 20.1% in the average was found corresponding to an enophthalmos of 3.5 mm in the average. Correlation between the severity of the enophthalmos and the increase in orbital volume was found. Enophthalmos could not be correlated to the intraorbital fat volume, especially no atrophy of orbital fat could be demonstrated in these patients. Normal orbital volume measurements of patients and dry skulls were compared to those found in the literature. Planning of the surgery was therefore facilitated before correction of enophthalmos, reconstruction of bony orbital contour after tumor resection and in patients with fibrous dysplasia. Results suggest that the bony orbital enlargement, followed by a change in soft-tissue shape and position is the usual cause for posttraumatic enophthalmos. Changes in volume of soft-tissues themselves are less significant.
在进行眼眶壁重建及其他涉及眼眶的手术操作，导致病理性改变的眼眶容积发生改变之前，测量这些容积有助于进行更精确的矫正。我们使用高分辨率计算机断层扫描对22例患者和6个干燥颅骨进行了眼眶容积研究。14例患者有各种原因导致的眼球内陷，3例患者患有累及眼眶的骨纤维异常增殖症，5例患者无眼眶病变。在10例单侧创伤后眼球内陷患者中，平均发现骨性眼眶容积增加20.1%，相应的平均眼球内陷为3.5毫米。发现眼球内陷的严重程度与眼眶容积增加之间存在相关性。眼球内陷与眶内脂肪容积无关，尤其是在这些患者中未发现眶内脂肪萎缩。将患者和干燥颅骨的正常眼眶容积测量结果与文献中的结果进行了比较。因此，在矫正眼球内陷、肿瘤切除后重建骨性眼眶轮廓以及骨纤维异常增殖症患者中，手术规划得以简化。结果表明，骨性眼眶扩大，随后软组织形状和位置发生改变，是创伤后眼球内陷的常见原因。软组织自身容积的变化不太显著。
