안와관통상으로 인해 발생한 상안와열증후군 경과관찰 1예
A Case of Superior Orbital Fissure Syndrome Induced by Penetrating Orbital Injury
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목적: 화분 철심에 의한 안와관통상 후 발생한 상안와열증후군과 그 임상적 회복 과정 1예를 경험하였기에 보고하고자 한다. 증례요약: 화분 지지대 철심에 우안 하외측 결막으로 안와 관통상을 입은 49세 여자로 수상 1시간 뒤 본원 내원 당시 우안은 최대교정시력이 0.8이었고 동공은 산대된 채 고정되어 있었다. 우안 상안검의 경한 안검하수와 전방향에서 안구운동장애를 보였으나, 전두부와 우안 상안검 주변의 감각이상은 관찰되지 않았다. 안저검사 및 시야검사상 특이소견은 보이지 않았다. 안와전산화단층촬영에서안와골절, 구후출혈, 이물 등의 소견은 보이지 않았다. 안와자기공명 영상에서는 눈 뒤쪽 안와 연부조직의 신호강도가 약간 증가된소견 이외에 외안근이나 시신경의 특이소견은 관찰되지 않았다. 상안와열증후군으로 진단하고 스테로이드 경구치료 후 수상 1개월째안검하수 및 안구운동장애의 호전과 동공반응의 일부 회복 소견이 보였고, 이후 수상 3개월째 동공반응의 완전 회복이 관찰되었다. 결론: 안와관통상 후 안와골절 없이 부종으로 인해 발생한 것으로 사료되는 상안와열증후군 환자에서 조직 부종을 경감시키는 목적으로 경구 스테로이드 치료를 시행하였고, 수상 3개월 후 증상은 호전되었다.
Abstract
Purpose: We report a case of superior orbital fissure syndrome induced by penetrating orbital injury caused by a steel wire andanalyzed the clinical outcomes. Case summary: A 49-year-old female visited our clinic after a penetrating orbital injury through the right inferolateral conjunctivacaused by a steel wire. The best corrected visual acuity of the right eye was 0.8 and a fixed dilated pupil was detected. Partialptosis and ophthalmoplegia were observed in the right eye. The computed tomography image revealed no sign of orbital wallfracture, retrobulbar hemorrhage or foreign body. Slightly increased signal intensity was observed on the magnetic resonanceimage but other abnormal findings of the extraocular muscle and optic nerve were not detected. Under the impression of superiororbital fissure syndrome, systemic steroid was administered orally. After 1 month, ptosis and ophthalmoplegia were partiallyimproved. After 3 months, the pupil size and response were normalized. Conclusions: The oral steroid treatment was given to reduce the edema without orbital wall fracture after the penetrating orbitalinjury, which caused the superior orbital fissure syndrome. The symptom was relieved 3 months after the injury.
참고문헌 (20)
- Chen CT., "Traumatic superior orbital fissure syndrome : current management", Craniomaxillofac Trauma Reconstr, 3, pp.9~16 (2010)
- Hirschfeld L., "Epanchement de sang dans le sinus caverneux du cote gauche diagnostique pendant la vie", Compt Rend Soc Biol, 138 (1858)
- Rai S., "Traumatic superior orbital fissure syndrome : Review of literature and report of three cases", Natl J Maxillofac Surg, 3, pp.222~225 (2012)
- Zachariades N., "The superior orbital fissure syndrome. Review of the literature and report of a case", Oral Surg Oral Med Oral Pathol, 53, pp.237~240 (1982)
- Chen CT., "Traumatic superior orbital fissure syndrome : assessment of cranial nerve recovery in 33 cases", Plast Reconstr Surg, 126, pp.205~212 (2010)
- Zachariades N., "The superior orbital fissure syndrome", J Maxillofac Surg, 13, pp.125~128 (1985)
- Antonyshyn O., "Blow-in fractures of the orbit", Plast Reconstr Surg, 84, pp.10~20 (1989)
- Sieverink NP., "Superior orbital fissure syndrome in a 7-year-old boy", Int J Oral Surg, 9, pp.216~220 (1980)
- Robinson DC., "Superior orbital fissure syndrome with Bell's palsy : report of case", J Oral Surg, 31, pp.203~206 (1973)
- Unger JM., "Sphenoid fractures : prevalence, sites, and significance", Radiology, 175, pp.175~180 (1990)
- Pogrel MA., "The superior orbital fissure syndrome : report of case", J Oral Surg, 38, pp.215~217 (1980)
- Bun RJ., "Traumatic superior orbital fissure syndrome : report of two cases", J Oral Maxillofac Surg, 54, pp.758~761 (1996)
- Postma MP., "Superior orbital fissure syndrome and bilateral internal carotid pseudoaneurysms", J Oral Maxillofac Surg, 48, pp.503~508 (1990)
- Rohrich RJ., "Superior orbital fissure syndrome : current management concepts", J Craniomaxillofac Trauma, 1, pp.44~48 (1995)
- Levin LA., "The treatment of traumatic optic neuropathy : the International Optic Nerve Trauma Study", Ophthalmology, 106, pp.1268~1277 (1999)
- Yip CC., "Low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy", Eur J Ophthalmol, 12, pp.309~314 (2002)
- Bracken MB., "Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury Study", JAMA, 277, pp.1597~1604 (1997)
- 한결, "안와관통상으로 인해 발생한 상안와열증후군 경과관찰 1예", 대한안과학회지, 56(4), pp.592~597 (2015), 대한안과학회[DOI]
- Kim SG., "Traumatic Superior orbital fissure syndrome complicating fractures of the facial skeleton : Report of a Case", J Korean Assoc Maxillofac Plast Reconstr Surg, 22, pp.356~359 (2000)
- Kim YI., "Case report of traumatic orbital apex syndrome and superior orbital fissure syndrome", J Korean Assoc Maxillofac Plast Reconstr Surg, 15, pp.275~280 (1994)