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目的评价颧眶复合体骨折合并眶底骨折的手术治疗效果。方法对81例眶颧复合体骨折合并眶底骨折患者根据骨折时间及部位选择性地采用冠状切口、下睑缘切口、口内切口,复位、固定骨折并行同期眶底重建,所有患者术前、术后均摄双眶水平及冠状位CT、头面部三维CT像,并进行比较。结果术后随访6～37个月,平均12.5个月,所有患者面形基本对称,开口度正常,58例复视基本消失,5例有不同程度改善;66例眼球内陷者中,60例基本矫正,4例内陷﹤2mm,2例内陷2～3mm。3例出现轻度下睑外翻,2例巩膜暴露,无人造骨片排异和移位出现。结论颧眶复合体骨折合并眶底骨折应根据患者症状确定是否行眶底探查,颧弓及颧蝶缝是骨折复位的重要参考点。
Objective To evaluate the surgical treatment of zygomatic orbital complex fractures complicated with orbital floor fractures. Methods Eighty-one cases of orbital zygomatic complex fractures complicated with orbital floor fractures were treated with coronal incision, lower eyelid incision, incision, reduction and fixation of the orbital floor simultaneously according to the fracture time and site. All patients underwent surgery After the double-orbital level and coronal CT, head and face three-dimensional CT images, and compared. Results The patients were followed up for 6 to 37 months with an average of 12.5 months. All the patients were basically symmetrical in shape and normal in opening degree, 58 cases of diplopia disappeared, and 5 cases improved in varying degrees. Among the 66 cases Basic correction, 4 cases of retraction <2mm, 2 cases of retraction 2 ~ 3mm. 3 cases of mild lower eyelid eversion, 2 cases of scleral exposure, no artificial bone row rejection and shift appear. Conclusion Zygomatic orbital complex fractures with orbital floor fractures should be determined according to the symptoms of patients with orbital floor exploration, zygomatic arch and zygomatic arch joint fracture reduction is an important reference point.