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传统的眼眶骨折手术是经皮肤或结膜的直接途径,能提供良好的手术视野,但手术创伤大,皮肤遗留瘢痕。鼻内镜手术照明好、多角度、视野清晰、入路简捷、可以微创的手术处理达到最佳的手术效果。鼻内镜下经筛窦/上颌窦入路适于复位单纯的眶壁骨折,直视眶壁后份骨折的骨质缺损以及突入到窦腔的眼眶内容物,并辅助眼眶骨折的临床诊断。鼻内镜手术联合其他经鼻外皮肤或结膜的入路,在修复鼻眶筛复合体骨折时优势明显。本文就鼻内镜在眼眶骨折中的诊断价值、鼻内镜手术治疗眼眶骨折的优缺点和临床指征、操作要点、植入材料以及骨折固定材料等方面作一综述。
Traditional orbital fracture surgery is the direct way of the skin or conjunctiva, can provide a good field of vision, but the surgical trauma, skin scar left. Endoscopic surgery lighting well, multi-angle, clear vision, access is simple, minimally invasive surgical treatment to achieve the best surgical results. Endoscopic sinus / maxillary sinus approach is suitable for the reduction of simple orbital fractures, orbital fracture of the back straight bone defects and the contents of the orbital into the sinus cavity, and to aid the clinical diagnosis of orbital fractures. Nasal endoscopic surgery combined with other transnasal skin or conjunctival approach, the repair of nasal orbital sieve complex fracture obvious advantages. This article reviews the value of endoscopic diagnosis of orbital fractures, the advantages and disadvantages of nasal endoscopic surgery for the treatment of orbital fractures and clinical indications, operating points, implant materials and fracture fixation materials are reviewed.