PROGNOSIS OF DIPLOPIA CAUSED BY ORBITAL WALL FRACTURES AND INDICATION FOR SURGERY

Abstract

To detect factors that may affect the prognosis of diplopia caused by orbital wall fractures, retrospectibely evaluated 82 cases were seen at the Saitama Medical School between January 1995 and July 1999. Of these, 44 (54%) reporting diplopia were divided into 2 groups. One in which diplopia lasted more than 1 month and one in which recovery occurred within 1 month. To study diplopia quantatively, the area within 15 degrees on the Hess chart was calculated and the ratio of area of affected side against that of normal side was obtained. Statistically, in patients in there low teens, cases with positive symptoms in the forced duction test and abnormalities in CT or MRI imaging tended to have a poor prognosis, indicating the need for early surgery. The absence of these factors suggested that a wait-and-see policy would produce a better prognosis. Keywords: Šáâ| •Ç•oe•Ü, •¡ Ž‹-\ OEã, Žè•p "K‰ž, ƒwƒXƒeƒXƒg, ƒoƒ‹ •[ ƒ"ƒJ ƒe-ƒe ƒ‹ ‚Í ‚ ¶ ‚ß ‚É Šá â| •Ç•oe•Ü ‚Í1957"N ‚ÉConverse‚ç1)‚AESmith‚ç5)‚É ‚ae ‚è"blow-outfracture"‚AE OEÄ •Ì ‚³ ‚ê ‚ÄˆÈ-ˆ, ‚±‚Ì-¼•Ì ‚â "-• ¶ ‹@•˜ ‚É'Î ‚· ‚é ‹»-¡ ‚È ‚Ç‚É‚ae ‚è-L-¼‚AE ‚È‚Á‚½•B-M OEê-ó ‚Í •• ‚«"² ‚¯ •oe•Ü, Šáâ| 'ê •oe•Ü‚È ‚Ç‚AE‚È‚é•BOE» •Ý‚Å‚Í Šá â| 'ê ‚Ì ‚Ý‚È ‚炸, Šáâ| •Ç‚Ì •oe•Ü‚É ‚ae ‚èŠáâ| "à-e ‚ª •› •@•o ‚É'E •o ‚µ‚½ ‚à ‚Ì, ‚· ‚È‚í ‚¿ Šáâ| "à•Ç, Šáâ| 'ê ‚Ì Šáâ| •Ç•oe •Ü‚ðblow-outfracture‚AE OEÄ ‚Ô‚Ì ‚ªˆê‚ªˆê "Ê"I ‚Å‚ ‚é•B•¡ ‰ñ ‚Í blow-outfracture-á ‚É‚Â‚¢ ‚Ä"Á‚É•¡ Ž‹-\ OEã, Žè•p "K‰ž ‚É ‚‚¢ ‚ÄOEŸ "¢ ‚µ‚½‚Ì ‚Å•ñ •• ‚· ‚é•B ‚³ ‚ç ‚É•¡ Ž‹ ‚Ì 'è-Ê ‰» ‚â •p Ž®‚É‚¨‚¯Ž®‚É‚¨‚¯ ‚é •H•v ‚ɂ‚¢ ‚Ä‚à•q ‚× ‚é•B 'Î •Û •E•û-@ 'Î •Û‚Í1995"N1OEŽ •`1999"N7OEŽ ‚Ü‚Å‚É•é ‹Êˆã 'å Ž¨•@ ˆô •A‰È ‚ðŽó•f ‚µ‚½Šáâ| •Ç•oe•Ü82-á•B OE» Žž"_ ‚Å'ʉ@ ‚µ‚Ä‚¢ ‚é•Ç-á ‚É‚Â‚¢ ‚Ä‚Í •Å•I Žó•f Žž‚Ì •¡ Ž‹ ‚Ì •ó 'Ô, 'ʉ@ ‚µ‚Ä‚¢ ‚È‚¢•Ç-á ‚Í, "d˜b ‚Å•¡ Ž‹ ‚Ì •ó ‹µ ‚ð-â•f ‚µ‚½•B"d˜b ‚Å‚à˜A‚Å‚à˜A-•‚Å ‚« ‚È‚¢ •Ç-á‚Í •Å•I Žó•f Žž‚Ì •¡ Ž‹ ‚Ì •ó 'Ô ‚ð ŽQ •l ‚É ‚µ ‚½•B•¡ Ž‹ ‚ð"F ‚ß ‚½-á ‚ð•¡ Ž‹ ‚ª1‚© OEŽˆÈOEŽˆÈ•ã ‚É‚í ‚½ ‚è Žc' ¶ ‚µ ‚½'J ‰" OEQ ‚AE1‚©OEŽˆÈ‚AE1‚©OEŽˆÈ "à ‚É•ÁŽ¸‚µ‚½ÁŽ¸‚µ‚½'• ŠúOEQ ‚É•ª-Þ: ‚µ, ˆÈ‰º ‚̈ö‚̈ö Žq‚ÉŠÖ‚µ‚Äretrospective‚É •· ˆÙ‚ðOEŸ "¢ ‚µ‚½•B 1. "N-î•E•« 2. •‰ •f ‚Ü‚Å‚Ì ŠúŠÔ 3. Žó•• OE´ˆö: OE´ˆö ‚ð'Î •l, ƒXƒ| •[ ƒc, 'Î •¨ ‚É•ª-Þ ‚µ‚Ä OEŸ "¢ ‚µ ‚½•B 4. OE¡ˆøŽŽOE± OE‹‰Ê: Šá‰ÈˆãŠá‰Èˆã ‚ª Ž{•s, "» 'è ‚µ,-¾‚ç ‚©‚É-z •« ‚Ì ‚à ‚Ì ‚AE ‚» ‚êˆÈŠO‚Å‚êˆÈŠO‚Å"ä Šr ‚µ‚½•B 5. •¡ Ž‹ ‚Ì-L-³ ‚AE 'ö "x: •¡ Ž‹ ‚Ì 'ö "x ‚ɂ‚¢ ‚Ä‚Í •V ‚µ ‚-•l ˆÄ‚µ ‚½ƒwƒX'S-Ê•Ï "ä(•}1)‚É ‚ÄOEŸ "¢ ‚µ ‚½•B 6. ‰ae 'oe•f 'f ‚AE ‚Ì ŠÖ˜AŠÖ˜A a. •oe•Ü•" ˆÊ; "à•Ç, Šáâ| 'ê,-¼ ŽÒ‚É‹y ‚Ô'ê "à•Ç ‚É•ª-Þ: ‚µ, ‚» ‚ê ‚¼‚ê ‚É‚Â‚¢ ‚Ä"ä Šr ‚µ‚½•B b. •oe•ÜOE`'Ô; •oe•Ü•Ð‚Ì •Î ˆÊ•ó 'Ô‚É‚ae ‚è"² ‚«'Å‚¿, ‚Í-(303)19