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作者报告两例翼管神经切断术后并发全眼肌麻痹,视力丧失,数周后其他神经恢复,但失明仍然存在。例一男性,经鼻内作翼管神经切断术。先作左侧,用鼻钳将中鼻甲扭转向上,切开粘膜,立即看到蝶腭动脉,以此为标志,凿开翼颌窝底部,很容易找到翼管神经,并切断之,用一小片特氟隆放在两断端之间,使神经不致再生。术后病人情况良好。因为效果满意,病人要求作右侧;手术方法与左侧完全一样。但麻醉醒后,病人右眼瞳孔放大,眼肌全部麻痹,上睑下垂,眼球固定,不能向任何方向转动,患者诉说失明。立即用血管扩张药及激素,并由一眼科医师作球后注射;眼球断层片检查未发现异常。3周后,眼肌麻痹完全恢复,但失明仍然存在。
The authors report two cases of pterygium, paresis and loss of vision after pterygotic excision. Other nerves recovered after a few weeks, but blindness persisted. A male, transnasal endovascular transection. First for the left, with the nose pliers to turn the middle turbinate upward, cut the mucosa, and immediately see the sphenopalatine artery, as a sign, the bottom of the jaw jaws scalloped, it is easy to find the pterygoid nerve, and cut off, with a Teflon small piece between the two ends, so that the nerve will not regenerate. Postoperative patients in good condition. Because the effect is satisfactory, the patient asks for the right; the method of surgery is exactly the same as the left. However, anesthesia woke up, the patient’s right eye pupil magnification, all paralysis of the eye muscle, ptosis, eye fixation, can not turn in any direction, the patient complained of blindness. Immediately vasodilators and hormones, and by an ophthalmologist after the ball injection; ocular fault examination found no abnormalities. After 3 weeks, ophthalmoplegia completely recovered, but blindness still existed.