Ashar A, Kovacs A, Khan S, Hakim J
Department of Oral and Maxillofacial Surgery, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates.
J Oral Maxillofac Surg. 1998 Oct;56(10):1146-50; discussion 1151. doi: 10.1016/s0278-2391(98)90757-1.
This study assessed the frequency of blindness associated with midfacial fractures and correlated this with the fracture pattern.
A retrospective analysis of 49 patients admitted with midfacial fractures from January 1995 to March 1997 was performed to determine the presence of posttraumatic blindness. The medical and radiological records of the patients with blindness were reviewed for age and sex, cause of the injury, type of facial fracture, type of ocular trauma, and probable cause of the blindness.
Ten of the 49 patients lost vision in one eye (20% of all midfacial fractures and 22% of midface fractures involving the orbit). The possibility of blindness associated with facial fractures was directly related to the severity of injury. Road traffic accidents were the most common cause. Blindness was attributable to traumatic optic nerve injury in seven cases and a ruptured globe in three cases.
The high frequency of blindness associated with midfacial fractures in this series was attributable to the predominance of road traffic accidents as the major cause and absence of an obligatory seat belt law. Early diagnosis of the exact nature of the ophthalmic injury and treatment are important, and involvement of the ophthalmologist is mandatory.
本研究评估了与面中部骨折相关的失明发生率，并将其与骨折类型相关联。
对1995年1月至1997年3月收治的49例面中部骨折患者进行回顾性分析，以确定创伤后失明的情况。对失明患者的医疗和放射学记录进行了审查，内容包括年龄、性别、受伤原因、面部骨折类型、眼外伤类型以及失明的可能原因。
49例患者中有10例单眼失明（占所有面中部骨折的20%，占累及眼眶的面中部骨折的22%）。与面部骨折相关的失明可能性与损伤严重程度直接相关。道路交通事故是最常见的原因。失明的原因在7例中是外伤性视神经损伤，3例中是眼球破裂。
本系列中与面中部骨折相关的高失明发生率归因于道路交通事故作为主要原因的主导地位以及缺乏强制性安全带法律。早期诊断眼部损伤的确切性质并进行治疗很重要，眼科医生的参与是必不可少的。
