- 期刊
Inferior Marginotomy for Retrieval of Entrapped Diplopia of Orbital Floor Blowout Fracture
經下眼緣骨片取出術復位崁閉軟組織治療純粹眼底破洞造成的複視
摘要
經眼底粗直的復位崁閉軟組織治療眼底破洞造成的複視常無法獲得充分視野而導致二度損傷。但暫時將部分下眼緣骨取下後可經由上額竇清楚見到崁閉的眼軟組織，同時可完整的將其復位至眼礬內，不會有併發症的産生。薄層電腦斷層掃描，精確估計眼底破洞及崁閉軟組織大小；經睫毛下切口，應用此法再加上矽片的覆蓋破洞而完成手術。我們治療七例，複視及眼球活動度於二個月內皆完全恢復，僅有三位患者有輕微臉頰麻痺。 結論：應用經下眼緣骨片取出術復位崁閉軟組織治療眼底骨折破洞，可確實快速而有效的解決此類患者造成複視的困擾。
關鍵字
無資料並列摘要
The treatment of entrapped diplopia using blunt traction of the herniated hour-glass orbital contents often leads to inadequate exposure or secondary trauma. Inferior marginotomy which allows temporary displacement of the inferior orbital rim provides direct visualization and complete retrieval of the herniated tisue without further complication. We reported seven patients with definite orbital floor fractures which confirmed by the thin-slice computed X-ray tomography and they received inferior marginotomy through the subciliary incision. We covered the floor defect by the usage of curved sizable silastic sheet implant. Diplopia resolved within 2 months postoperation and restored full ocular motility. Only three patients experienced side effects of mild cheek numbness. The use of inferior marginotomy to treatment orbital floor blowout fracture provided excellent expousure which allowed complete retrieval of entrapped orbital soft tissue with no trauma, It was also used to obtained definite and uncomplicated, quick resolved results in these difficult to treat patients with diplopia.
延伸閱讀
- 江珊玲、梁凱莉、江榮山（2007）。以內視鏡手術治療非創傷性眼窩骨膜下血腫。台灣耳鼻喉頭頸外科雜誌，42(4)，136-139。https://doi.org/10.6286/2007.42.4.136
- Chen, S. Y., Tsai, Y. J., Ma, L., Wu, S. Y., & Chu, Y. C. (2010). 經內眥及下結膜穹窿施行內眼窩骨眼窩底骨折重建術後下斜肌脫位之後遺症－病例報告. 中華民國眼科醫學會雜誌, 49(4), 610-615. https://doi.org/10.30048/ACTASOS.201012.0014
- Chung, C. J., & Chung, C. H. (1998). 利用腹直肌自由肌皮瓣術併帶血管莖肋軟骨重建眼窩及上顎缺損. 中華民國重建整形外科醫學會雜誌, 7(1), 63-67. https://doi.org/10.7096/JPRSA.199803.0013
- Kahn, M. T., Yau, C. W., Fu, Y. A., Ma, L., & Kao, J. (1989). 孤立性之內眼窩壁骨折併眼球內陷以Proplast重建. 中華民國眼科醫學會雜誌, 28(1), 371-376. https://doi.org/10.30048/ACTASOS.198905.0068
- Wang, H. Z., Lai, S., & Chang, C. H. (1995). 以鈦金屬網板重建未完全復位顴上顎骨折所合併之眼窩底骨折. The Kaohsiung Journal of Medical Sciences, 11(6), 359-365. https://doi.org/10.6452/KJMS.199506.0359