‘Orbital volume restoration rate after orbital fracture’; a CT-based orbital volume measurement for evaluation of orbital wall reconstructive effect

Abstract

PurposeTo evaluate the effect of orbital reconstruction and factors related to the effect of orbital reconstruction by assessing of orbital volume using orbital computed tomography (CT) in cases of orbital wall fracture.MethodsIn this retrospective study, 68 patients with isolated blowout fractures were evaluated. The volumes of orbits and herniated orbital tissues were determined by CT scans using a three-dimensional reconstruction technique (the Eclipse Treatment Planning System). Orbital CT was performed preoperatively, immediately after surgery, and at final follow ups (minimum of 6 months). We evaluated the reconstructive effect of surgery making a new formula, 'orbital volume reconstruction rate' from orbital volume differences between fractured and contralateral orbits before surgery, immediately after surgery, and at final follow up.ResultsMean volume of fractured orbits before surgery was 23.01±2.60 cm and that of contralateral orbits was 21.31±2.50 cm (P=0.005). Mean volume of the fractured orbits immediately after surgery was 21.29±2.42 cm, and that of the contralateral orbits was 21.33±2.52 cm (P=0.921). Mean volume of fractured orbits at final follow up was 21.50±2.44 cm, and that of contralateral orbits was 21.32±2.50 cm (P=0.668). The mean orbital volume reconstruction rate was 100.47% immediately after surgery and 99.17% at final follow up. No significant difference in orbital volume reconstruction rate was observed with respect to fracture site or orbital implant type. Patients that underwent operation within 14 days of trauma had a better reconstruction rate at final follow up than patients who underwent operation over 14 days after trauma (P=0.039).ConclusionComputer-based measurements of orbital fracture volume can be used to evaluate the reconstructive effect of orbital implants and provide useful quantitative information. Significant reduction of orbital volume is observed immediately after orbital wall reconstruction surgery and the reconstruction effect is maintained for more than minimum 6 months. Patients that undergo surgery within 14 days of trauma has better reconstruction rates at final follow up, which supports the need for early surgery.

Dose reduction in CT imaging for facial bone trauma in adults: A narrative literature review

“…MRI could be used if additional pre‐operative imaging is required, provided that the long scan time is not a concern and there are no contraindications . The need for additional imaging following a facial trauma CT is typically negated by the reconstruction and 3D modelling capabilities of MDCT, which allow for comprehensive assessment of the face including the intricate orbital region …”

“…Image processing, artefact suppression of dental amalgam, multi‐planar reconstructions and 3D imaging, can be used to optimise spatial and contrast resolution and provide a comprehensive view of the facial anatomy (Fig. ) . This technology also allows for treatment planning and post‐operative assessments .…”

“…) . This technology also allows for treatment planning and post‐operative assessments . 3D models from pre‐operative scans facilitate personalised surgical planning including the design of custom reconstructive metal plates …”

Reconstruções orbitárias: relato de três casos

“…Elas são limitadas superiormente pela calota craniana, medialmente pelas células etmoidais, inferiormente pelo seio maxilar e lateralmente pela fossa zigomática. Cada espaço orbitário é formado por sete componentes ósseos, sendo eles: face orbital do osso frontal; face orbital do osso zigomático; face orbital da maxila; osso lacrimal; lâmina orbitária do osso etmoide; face orbital do osso esfenoide; processo orbitário do osso palatino 1 .…”

“…Enquanto outros afirmam que as fraturas sintomáticas devem receber tratamento cirúrgico imediato para minimizar sequelas 7 . Em relação aos casos de intervenção cirúrgica, estudos apontam que melhores resultados são obtidos se executada a intervenção até quatorze dias após o trauma 1 .…”