학동기이전 소아 안와골절 환자의 임상양상과 예후
Prognosis and Clinical Features of Orbital Wall Fracture in Preschool Children
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목적: 7세 이하의 소아 안와골절 환자에서 골절원인 및 형태 등의 임상양상과 예후를 알아보고자 하였다. 대상과 방법: 2001년 1월부터 2009년 10월까지 안와골절로 진단받은 학동기이전의 소아 환자 11명 11안을 대상으로 골절의 원인, 위치및 형태 등의 임상양상을 분석하고 최종 경과 관찰 시 복시 및 안구운동장애 등의 예후를 알아보았다. 결과: 환자의 평균 나이는 5.36세였으며 원인은 교통사고가 5예(45%)로 가장 많았고 골절위치는 하벽이 7예(63%)로 가장 많았으며골절의 형태는 들창문형(trapdoor type)이 7명(63%)으로 가장 많았다. 특히 들창문형 골절 환자 7명 중 7명(100%) 모두에서 오심, 구토등의 동반증상이 관찰되었다. 수술을 시행한 환자는 11명 중 8명이었는데 수상 후 수술 시행까지의 기간은 평균 4.75일이었다. 수술을시행한 환자들에서 최종 경과 관찰 시 8명 중 8명(100%) 모두에서 안구 운동장애와 주변부 시야에서 복시가 남아 있었다. 결론: 학동기 이전의 소아 안와골절 환자는 오심, 구토 등의 전신 동반 증상이 많았고, 수술 후에도 안구 운동장애, 복시 등이 남아있었다.
Abstract
Purpose: To evaluate the clinical aspects associated with the preoperative and postoperative state of blow-out fractures in preschool children. Methods: The authors of the present study retrospectively reviewed 11 cases of blow-out fracture repaired by orbital reconstruction. Results: The most common cause of fracture was a traffic accident (45%); there were 7 cases (63%) of inferior wall fracture and 7 cases (63%) of trapdoor-type fracture. All patients with trapdoor-type fractures had nausea and vomiting. After the operation, the majority of patients (88%) had mild ocular motility restriction and diplopia. Conclusions: In preschool children, systemic symptoms such as nausea and vomiting presented frequently. In addition,complications such as restriction in ocular movement and diplopia often developed postoperatively.
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