摘要
目的 探讨利用微创技术羟基磷灰石复合人工骨修复爆裂性眶壁骨折的临床效果.方法 回顾性分析2008年3月至2010年4月河北医科大学第三医院爆裂性眼眶壁骨折患者21例,鼻内窥镜下窦腔入路,将羟基磷灰石复合人工骨片以桥板式修复骨孔,定期随访6个月,观察预后,评价该方法对功能恢复与解剖复位的效果.结果 患者术后均无视力下降及丧失,无感染,骨片无移位、滑脱.随访3个月后复视消失17例,周边视野残余复视2例,第一眼位存在复视2例,其中1例眼球偏斜.6个月后周边视野残余复视患者无明显改善,第一眼位仍存在复视2例,1例眼球偏斜未能恢复.其中复视患者2例给予眼外肌手术进行了矫正.眼球突出度：与健侧眼比较,内陷≤2 mm者18例,内陷＞2 mm者2例,内陷＞4 mm者1例.眼球被动牵拉试验阳性1例.CT扫描：21例均无骨片移位、滑脱.结论 此方法结合了鼻内窥镜窦腔入路与羟基磷灰石复合人工骨片的优势,手术效果肯定,有一定推广意义.
Objective To explore a minimally invasive technique with hydroxylapatite artificial bone to repair the orbital blowout fracture.Methods Twenty-one cases of orbital blowout fracture from March 2008 to April 2010 were enrolled.And the fractures were repaired with a bridge of hydroxylapatite artificial bone under a nasal endoscope.During a regular 6-month follow-up,anatomic and functional recovery was evaluated.Results There was neither postoperative visual loss nor infection in all cases.At 3 months postoperation,diplopia vanished completely （n = 17）,remained in peripheral vision （n = 2）,existed in primary ocular position （n = 2） and the deviation of eyeball （n = 1）.At Month 3,diplopia in peripheral vision or in primary position and the deviation of eyeball showed no improvement.Compared with the uninjured side,enophthalmos：≤2 mm （n = 18）,＞ 2 mm （n= 2） and ＞ 4 mm （n = 1）.The passive traction test was positive in one case.On computed tomograph （CT） scanning,there was no bone dislocation or slippage in all cases.Conclusion The surgical efficacy is excellent.The technique of combining the advantages of endoscopic sinus approach and hydroxyapatite artificial bone is worth a wider popularization.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2011年第11期778-780,共3页
National Medical Journal of China
关键词
鼻内窥镜
羟基磷灰石复合人工骨
微创技术
Nasal endoscope
Hydroxylapatite artificial bone
Minimally invasive technique
