Scassellati-Sforzolini G, Cavina C, Scassellati-Sforzolini B, Vancini F, Cavina C
Casa di cura Villa Verde, Bologna, Italy.
Int Ophthalmol. 1997;21(6):353-8. doi: 10.1023/a:1006023831029.
Isolated fractures of the medial orbital wall are infrequent. The diagnostic triad includes: adduction block, exotropia with diplopia in all directions of gaze, positive passive duction in abduction. Sometimes a slight enophthalmos is present. Computed tomography shows the extension and the seat of the fracture.
The authors illustrate the case of a 60 year old male who presented with a breach of the medial orbital wall following endonasal surgery.
The patient was successfully operated using an iliac bone graft inserted via an eyebrow-nasal cutaneous approach, after a previous attempt with a transconjunctival approach performed in another hospital had failed. A good functional and aesthetic result was observed within the first year after surgery. After almost 11 years a full adduction is still present and diplopia is absent.
The authors underline the importance of an early diagnosis and prompt surgical treatment. The fat-muscle entrapment should be removed and the bone defect closed. A close cooperation between ophthalmologist and plastic surgeon is suggested.
眼眶内侧壁孤立性骨折并不常见。诊断三联征包括：内收受限、各方向注视时伴有复视的外斜视、外展时被动牵拉试验阳性。有时会出现轻度眼球内陷。计算机断层扫描显示骨折的范围和部位。
作者阐述了一名60岁男性患者的病例，该患者在内鼻手术后出现眼眶内侧壁破裂。
在另一家医院先行经结膜入路手术失败后，通过眉鼻皮肤入路植入髂骨成功为该患者实施了手术。术后第一年观察到良好的功能和美学效果。术后近11年，患者仍能完全内收且无复视。
作者强调早期诊断和及时手术治疗的重要性。应解除脂肪肌肉嵌顿并封闭骨缺损。建议眼科医生和整形外科医生密切合作。
