Can Systematic Computed Tomographic Scan Assessment Predict Treatment Decision in Pure Orbital Floor Blowout Fractures?

Schouman, Thomas; Courvoisier, Delphine S.; Issum, Christopher Van; Terzic, A.; Scolozzi, Paolo

doi:10.1016/j.joms.2012.03.006

Cited by 47 publications

(49 citation statements)

References 16 publications

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“…The association between a high MSS score and the development of diplopia and/or enophthalmos 6 months after trauma enabled them to build a treatment algorithm. The MSS also emerged in the study by Schouman et al 10 as the main predictive factor in the treatment decision making process for pure BOF.…”

Section: Discussionmentioning

confidence: 85%

“…Previous studies showed their high accuracy, reliability, and reproducibility. 9,10 The RF was known to be correlated with the degree of enophthalmos during the initial phase of trauma, especially if the bone defect was in the posterior orbital cone. 3,10,22 Contrary to previous studies that showed no association between fracture size and long-term clinical outcome, a significant correlation emerged in our study between RF and the severity of enophthalmos after 6 months, independently of surgical correction.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 The RF was known to be correlated with the degree of enophthalmos during the initial phase of trauma, especially if the bone defect was in the posterior orbital cone. 3,10,22 Contrary to previous studies that showed no association between fracture size and long-term clinical outcome, a significant correlation emerged in our study between RF and the severity of enophthalmos after 6 months, independently of surgical correction. 14,21,22 Our results also demonstrated a correlation between MH and the persistence of binocular diplopia as well as the severity of the ocular motility restriction.…”

Section: Discussionmentioning

confidence: 99%

“…For each patient, the following 3 parameters were calculated according to the computational method previously described and validated by Schouman et al 9,10 (1) Area ratio of the fractured orbital floor (RF ¼ fracture area/ total orbital floor area) (Fig. 1).…”

Section: Computer Image Analysismentioning

confidence: 99%

“…Multiple radiologic diagnostic criteria developed using computed tomography (CT) have tried to establish the relationships between the images observed and the associated clinical signs and symptoms. [3][4][5][6][7][8][9][10] Some of these criteria have already demonstrated their utility and reliability for a therapeutic decision-making strategy for pure BOFs. 6,10 Studies have been mainly focused on the prevalence of diplopia in patients with BOFs, the possible association between orbital volume and severity of enophthalmos development and the possible beneficial effect of surgical treatment on the functional status of ocular motility.…”

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confidence: 99%

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Can a Specific Computed Tomography-Based Assessment Predict the Ophthalmological Outcome in Pure Orbital Floor Blowout Fractures?

Bruneau

Haller

Courvoisier

et al. 2016

Journal of Craniofacial Surgery

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The aim of this study was to determine the predictive value of a specific computed tomography (CT)-based assessment for the final functional ophthalmological outcome in pure orbital floor blowout fractures. Data of 34 consecutive patients with pure blowout fractures who had undergone a period of at least 6 months of medical and ophthalmological follow-up were analyzed. The following 3 CT scan-based parameters were included: area ratio of the fractured orbital floor (RF), maximum height of periorbital tissue herniation (MH), and a 4-grade muscular subscore (MSS) describing the inferior rectus muscle displacement relative to the orbital floor level. The orthoptic complications (diplopia, enophthalmos, and ocular motility restriction) were evaluated by an experienced strabologist. The CT parameters' predictive value was analyzed using receiver operating characteristic curves and area under the curve (AUC), logistic regression, and Spearman correlation.The RF had a significant predictive value for enophthalmos appearance (AUC ¼ 0.75, P ¼ 0.02), and MH for diplopia (AUC ¼ 0.80, P ¼ 0.03). Among patients with complications, the relevance of MSS and MH as well as the severity of vertical deviation were also clinically strongly associated (rho ¼ À0.52 and À0.56).Our study revealed the significantly predictive value of RF for occurrence of enophthalmos and of MH for diplopia persistence. Although statistically unable to predict the occurrence of ocular motility restriction, MH and MSS were clinically strongly correlated with the severity of ocular deviation limitations.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Computer Image Analysismentioning

confidence: 99%

mentioning

confidence: 99%

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Can a Specific Computed Tomography-Based Assessment Predict the Ophthalmological Outcome in Pure Orbital Floor Blowout Fractures?

Bruneau

Haller

Courvoisier

et al. 2016

Journal of Craniofacial Surgery

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Clinical evaluation of the efficacy of materials used for primary reconstruction of orbital floor defects: Meta‐analysis

Hardouin

Fauvel

et al. 2020

Head & Neck

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Background: The aim of this network meta-analysis (NMA) was to compare the clinical results obtained after primary reconstruction of orbital floor fractures (OFF) using different materials. Methods: PubMed, Cochrane, and Google Scholar databases were screened from 1989 to 2019. For a study to be eligible, it had to evaluate two or more materials and report the following clinical parameters: diplopia and/or enophthalmos and/or other complications. Results: Nine studies involving 946 patients presenting with an OFF were included. After the surgical procedure, 105 patients (11%) had diplopia, while 43 patients (4.5%) suffered from enophthalmos. The NMA revealed that less postoperative diplopia and enophthalmos were obtained either by using polydioxanone (PDS), or a polymer of L-lactic acid and DL-lactic acid (P[L/DL]LA), or porous polyethylene, or titanium mesh compared with the use of autologous bone grafts. Conclusion: P(L/DL)LA and PDS seem to be the best options for small and intermediate defects, whereas the association of porous polyethylene and titanium should be preferred for larger defects.

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Orbital floor fractures—a comparison between CT images and findings at surgery

Folkestad

Jönsson

Karlsson

2023

Eur Arch Otorhinolaryngol

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Purpose The present study aims to investigate how well CT images correlate to surgical findings in orbital floor fractures and to the presence of diplopia. Methods In this cross-sectional study, 27 consecutive patients already selected for surgery due to an orbital floor fracture underwent a routine CT scan (axial, coronal, sagittal). An ophthalmologist established any presence of diplopia. Extent of fracture/injury seen on CT was compared to that discovered during surgery. Results In the surgeons´ opinions CT-images were in concordance with surgical findings in 71% of the cases. Agreement for pure blow out fractures was high (92%). Tetrapod fractures as a cause of an orbital floor fracture was only identified as such by surgeons in three of 11 cases, all subjected to orbital exploration, not only a closed reduction. Diplopia showed a significant correlation to rounding of the inferior rectus muscle at coronal CT. “Rounding” significantly correlated with the presence of a floor defect, to herniation of soft tissues and to the volume of displaced tissue. Conclusions The results imply that the joint professional interaction between neuroradiology and surgery is important and would benefit from the use of an easy and well-defined classification system of orbital floor fractures. In Sweden a national record to collect data on all zygomaticomaxillary complex fractures assessed is to be started aiming at making general statements possible by time.

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Can Systematic Computed Tomographic Scan Assessment Predict Treatment Decision in Pure Orbital Floor Blowout Fractures?

Cited by 47 publications

References 16 publications

Can a Specific Computed Tomography-Based Assessment Predict the Ophthalmological Outcome in Pure Orbital Floor Blowout Fractures?

Can a Specific Computed Tomography-Based Assessment Predict the Ophthalmological Outcome in Pure Orbital Floor Blowout Fractures?

Clinical evaluation of the efficacy of materials used for primary reconstruction of orbital floor defects: Meta‐analysis

Orbital floor fractures—a comparison between CT images and findings at surgery

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