Relative Difference in Orbital Volume as an Indication for Surgical Reconstruction in Isolated Orbital Floor Fractures

Craniomaxillofacial Trauma and Reconstruction

Babak Alinasab¹  Saber Abdi²  Pär Stjärne¹  Anders H. Westermark¹  Tony Pansell²  Mats O. Beckman³ 

[1] Division of Otorhinolaryngology, Department of Clinical Sciences, Intervention and Technology, Solna;Division of Ophthalmology, Department of Clinical Neuroscience, St. Erik Eye Hospital, Stockholm, Sweden;Department of Radiology, Karolinska Hospital, Solna

关键词: Orbital floor fracture;    blowout fracture;    orbital volume;    nonsurgical treatment;   

DOI  :  10.1055/s-0031-1286117

学科分类：口腔科学

来源: Thieme Medical Publishers, Inc.

【 摘 要 】

In orbital floor fractures, the estimation of the herniated orbital content in the maxillary sinus has traditionally been the dividing line between surgical and nonsurgical management. In this study, we evaluated whether a relative change in volume would function as an indicator for surgical versus nonsurgical treatment of orbital floor fractures. This was a follow-up study in patients with untreated unilateral isolated orbital floor fractures admitted to our department from March 2003 to April 2007. Patients were contacted by regular mail and invited to have a clinical eye examination. The volume of the orbital content was calculated digitally from the patients' computed tomography scans at the time of their injury. Eighteen subjects with no facial skeleton fracture were included for reference of orbital content volumes. Five of 23 patients showed 2 to 4 mm of enophthalmos, and only three of them had intermittent diplopia. No statistical correlation was found between the herniated volume and enophthalmos. No statistical correlation supporting the supposition that 1 mL of herniated orbital content would result in 1 mm of enophthalmos was found. The relative volume change between the fractured and nonfractured orbit in an individual does not appear to be a useful criterion for surgery. The importance of the herniated orbital tissue for the development of enophthalmos is unclear.

【 授权许可】

Unknown