颅颌面外伤主要由口腔颌面外科医生诊断和管理。在遇到的案件中,涉及眶壁的中面骨折非常普遍。在这些骨折中,轨道壁的参与,特别是轨道的地板,会导致相当大的美学和功能限制。从颌面部的角度来看,眼眶底手术修复的适应症包括眼动力明显下降,影响50%以上表面积的断裂,眼眶体积增加超过18%,眼球内陷大于2毫米。如果没有这些明显的迹象,通常不需要手术干预。然而,在这种情况下,8个月前有中面外伤和轻微眶底骨折病史的早期青少年表现为渐进性延迟性眼球内陷和眼球下移,与无症状窦综合征的特征非常相似.通过在眶底放置定制的不可吸收的高密度聚乙烯植入物来矫正眼球内陷和下眼球。术后随访显示美学和功能令人满意的结果。
Craniomaxillofacial trauma is primarily diagnosed and managed by oral and maxillofacial surgeons. Among the cases encountered, midface fractures involving orbital walls are highly prevalent. In these fractures, involvement of the orbital walls, particularly floor of the orbit, can lead to considerable aesthetic and functional limitations. From a maxillofacial perspective, indications for surgical repair of orbital floor encompass marked decrease in ocular motility, fracture affecting more than 50% of surface area, an increase in orbital volume exceeding 18% and enophthalmos greater than 2 mm. In the absence of these discernible signs, surgical intervention is not generally indicated. However, in this case, an early adolescent with a history of midface trauma and minimal orbital floor fracture 8 months earlier presented with progressively delayed onset enophthalmos and hypoglobus closely resembling features of silent sinus syndrome. The enophthalmos and hypoglobus were corrected by placing custom-made non-resorbable high-density polyethylene implant in the orbital floor. Postoperative follow-up demonstrated aesthetically and functionally satisfactory outcomes.