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眶颧复合体骨折治疗后的眶下神经功能:一种多测试方法。

Infraorbital nerve function following treatment of orbitozygomatic complex fractures. A multitest approach.

作者信息

Vriens J P, van der Glas H W, Moos K F, Koole R

机构信息

West of Scotland Regional Plastic and Maxillofacial Surgery Unit, Bearsden, Glasgow, UK.

出版信息

Int J Oral Maxillofac Surg. 1998 Feb;27(1):27-32. doi: 10.1016/s0901-5027(98)80091-x.

Abstract

Sensory disturbance following orbitozygomatic complex fractures was studied in 65 patients in relation to type of fracture and method of treatment. The fracture-type-dependent treatments were: no surgical intervention (n = 20), closed reduction with or without wire fixation (n = 17), open reduction with miniplate fixation (n = 15) and/or reconstruction of the orbital floor (n = 13). Several methods were applied to assess sensory function, on average 6.3 months after treatment, i.e. the patient's report and tests regarding touch, two methods of two-point discrimination, and cold, all applied on the cheek and upper lip. The various examinations indicated that, on average, the long-term sensory disturbance was most pronounced and severe in patients who underwent closed reduction without miniplate fixation. As the sensory disturbance of patients with open reduction and miniplate fixation approached the base-line level of patients for whom surgical intervention was not indicated, open reduction with miniplate fixation can be recommended as treatment for frontozygomatic suture fractures. The degree of sensory disturbance of patients who underwent orbital floor reconstruction was intermediate compared to patients with closed and open reduction respectively.

摘要

对65例眶颧复合体骨折患者的感觉障碍情况进行了研究,分析其与骨折类型及治疗方法的关系。根据骨折类型进行的治疗包括:不进行手术干预(n = 20)、闭合复位加或不加钢丝固定(n = 17)、切开复位微型钢板固定(n = 15)和/或眶底重建(n = 13)。采用了多种方法评估感觉功能,平均在治疗后6.3个月进行,即患者报告以及针对触觉、两种两点辨别觉方法和冷觉的测试,所有测试均在脸颊和上唇进行。各项检查表明,平均而言,未行微型钢板固定的闭合复位患者长期感觉障碍最为明显和严重。由于切开复位微型钢板固定患者的感觉障碍接近未行手术干预患者的基线水平,因此对于额颧缝骨折,可推荐采用切开复位微型钢板固定治疗。与闭合复位和切开复位患者相比,接受眶底重建患者的感觉障碍程度居中。

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