【摘要】 目的探讨预成形钛网经单一下睑缘切口治疗眼眶内、下壁联合骨折的临床效果及其安全性。方法回顾性总结2008年1月至2009年6月收治的18例眼眶内、下壁联合骨折患者。术前眼球内陷(与健眼差值-3～-6mm)18例,眼肌运动受限8例,复视6例。所有患者均经下睑缘皮肤切口行眶壁骨折整复术,植入预成形钛网修复骨折缺损。术后随访6～12个月,平均8.9个月。术前、术后行眼眶CT水平及冠状位扫描并进行比较。结果眼球内陷矫正(与健眼突出度差值≤±1.5mm)14例,眼球内陷改善(与健眼差值-2～-3mm)4例;眼球运动受限完全矫正5例,明显改善3例;5例患者复视完全消失,1例患者复视有所改善。18例患者手术前后视力无明显改变,未出现溢泪、钛网感染、排异和移位等并发症。CT显示钛网重建骨壁位置与健侧骨壁对称。结论应用预成形钛网治疗眼眶内、下壁联合骨折安全、有效,且钛网重建骨壁位置更加精确、稳定。更多还原

【Abstract】 Objective To explore the clinical efficacy and safety of prefabricated titanium mesh for fracture at medial orbital wall and infraorbital wall with an incision at lower limbus palpebralis.Methods A total of 18 cases with fracture at medial orbital wall and infraorbital wall were retrospectively analyzed from January 2008 to June 2009.There were 18 cases with endophthalmos(differences with normal eye were-3 mm to-6 mm),8 cases with restricted movement of muscular apparatus and 6 cases with diplopia preoperatively.All patients were taken diorthosis of orbital fracture with an incision at lower limbus palpebralis to implant prefabricated mesh for repairing fracture.The follow-up time was from 6 months to 12 months(mean 8.9 months).The orbital norizontal and coronal position were scaned by CT and compared before and after operation.Results Endophthalmos was corrected in 14 cases(differences with normal eye were be and less than ±1.5 mm),and improved in 4 cases(differences with normal eye were-2 mm to-3 mm).Restricted movement of eyeball was completely corrected in 5 cases,and obviously improved in 3 cases.Diplopia was completely disappeared in 5 cases,and improved in 1 case.Visual acuity was without obvious change in 18 cases postoperatively.Complications as epiphora,infection of prefabricated titanium mesh,rejection and displacement were not found.CT showed location of reconstructed orbital wall with prefabricated titanium mesh was in symmetry with orbital wall of the contralateral normal eye.Conclusions Application of prefabricated titanium mesh is a safe and effective way for fracture at medial orbital wall and infraorbital wall,and the location of reconstructed orbital wall with prefabricated titanium mesh is accurate and stable.更多还原