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目的:探讨鼻内镜下鼻中隔软骨修复治疗爆裂性眼眶内侧壁骨折的临床效果。方法:在鼻内镜下将骨折复位,将眶内容物还纳,以自体鼻中隔软骨植入骨折缺损处修复眶壁缺损,观察患者手术前后视力、复视、眼球突出度和眼位变化。结果:术后随访3个月～4年,28例患者术后均未出现患眼明显视力下降和视力丧失,术后眼球内陷度数为(1.5±0.6)mm,与术前(3.6±1.1)mm相比,差异有统计学意义(P<0.05)。术后3个月,25例患者复视完全消失,2例患者第一眼位无复视,但仍有周边复视,1例术后第一眼位复视仍存在。26例术后眼球运动基本恢复正常,2例外展稍受限,但较术前好转。以上28例患者均未发现填充物移位、感染或排异反应。结论:鼻内镜下鼻中隔软骨修复爆裂性眼眶内侧壁骨折具有手术入路简捷、视野清晰、操作简便、损伤小、无面部瘢痕等优点,效果确信可靠。
Objective: To investigate the clinical effect of nasal endoscopic septal cartilage repair in the treatment of burst orbital wall fracture. Methods: The fracture was removed under nasal endoscope, and the orbital contents were also recovered. Orbital defects were repaired with autologous septal cartilage implanted in the fracture defect. Visual acuity, diplopia, ocular protrusion and eye position were observed before and after surgery. Results: All patients were followed up for 3 months to 4 years. No obvious visual acuity and visual loss were observed in 28 eyes. The degree of sacosis was (1.5 ± 0.6) mm after surgery, compared with 3.6 ± 1.1 ) mm, the difference was statistically significant (P <0.05). Three months after surgery, 25 patients with diplopia disappeared completely, 2 patients without diplopia in the first position, but there are still peripheral diplopia, 1 case after the first ocular diplopia still exists. The eye movement returned to normal in 26 cases, and the extension of 2 cases was limited, but the improvement was better than that before operation. The above 28 patients did not find the filler displacement, infection or rejection. CONCLUSION: Nasal endoscopic septal cartilage repair of orbital orbital wall fracture with simple surgical approach, clear vision, easy operation, less damage, no facial scar, etc., the effect of convincing and reliable.