Correction of traumatic eyeball depression by bone grafting through a conjunctiva approach

目的 探讨在不增加面部皮肤瘢痕的情况下,经结膜入路手术植骨矫正外伤性眼球凹陷的疗效.方法 6例眶周骨折导致眼球明显凹陷畸形的患者,在局部麻醉下,根据眶壁骨折的不同部位,选择不同部位的结膜切口入路.眶内侧壁骨折选择内侧结膜入路,眶外侧壁骨折选择外侧结膜入路,眶下壁骨折选择下结膜等入路行自体骨移植填充术,通过CT检查预估眶腔需要缩小的程度,决定用以填充眶腔矫治眼球凹陷畸形移植骨块大小.结果 6例术后眼球凹陷畸形改善明显；由于手术采用局部麻醉,术中对眼球的活动功能和视力变化均可随时进行监测和调整,患者术后眼球活动功能、视力均未受不良影响；并且创伤小、术后恢复快,面部无新增皮肤切口瘢痕.结论 局部麻醉下经结膜入路自体骨移植是矫正眼球凹陷畸形,比较安全有效的方法.Objective To explore the corrective effect of traumatic eyeball depression through bone grafting without extra facial skin incision.Methods Six cases of traumatic fracture of all around eye socket with obvious eyeball depression deforming were treated.Under the local anaesthesia,the corresponding conjunctiva approaching was chosen according to the site of orbital fracture.Bone grafting with medial conjunctiva approach was chosen to the medial eye socket wall fracture,the lateral conjunctiva approach was chosen to the lateral wall fracture,and the inferior conjunctiva approach was chosen to the inferior wall fracture.The size and the shape of bone transplant should be estimated by the CT films previously.Results All the six cases were obviously improved.As the surgery was performed under the local anaesthesia,the movement of eyeball and the vision could be adjusted and be kept watch on timely.The surgery was less trauma and easy recovery,without new skin incision and eyeball functioning affection for all six cases.Conclusions The surgical approach is one of a way of reforming eyeball depressing.中国科技核心期刊(ISTIC)04256-2591