眼窩内側壁Blow out fracture—Tantalum meshによる整復

Blow Out Fracture of the Medial Orbital Wall: Plastic repair with tantalum mesh

I．はじめに

　眼窩損傷で複視を訴えるものには，眼球外眼筋の眼窩骨折部位への嵌頓がその原因となっている場合がある．1943年，Pfeifferが初めて眼球外眼筋のentrapmentによる眼球運動障害を記載し^11），1957年，Smithらはこうした骨折にblow out fractureの用語を初めて用いた^15）．眼窩のblow out fractureは，眼窩下壁に生ずることが多い，しかし内側壁のみが破裂骨折を起こすこともあり，内側壁が骨折した症例は1965年Rougierの報告^13）が最初と思われる．われわれは内側壁blow out fractureの2症例に，経眼窩的にtantalum meshを用いて整復と再脱出予防の手術を行い良好な成績を得たので報告する．

Two cases of blow out fracture of the medial orbitalwall were reported. The one was a 14 year-old boyand the other was a 32 year-old man. After hittingthe eye against another man or a hard object, thepatients felt diplopia, especially on lateral gaze towardthe injured side.

The blow out fracture was able to be diagnosed byplain roentgenography or tomography. The fracturedbone as well as the entrapped soft tissue were clearlydetected by CT scan. The fractures occurred at thethinnest part of the Lamina orbitalis ossis ethmoidalis(Lamina papyracea) in both cases.