Prediction of the Development of Late Enophthalmos in Pure Blowout Fractures: Delayed Orbital Tissue Atrophy Plays a Major Role

Kim, Sue Min; Jeong, Yeon Seong; Lee, Il Jae; Park, Myong Chul; Park, Dong Ha

doi:10.5301/ejo.5000801

Cited by 24 publications

(19 citation statements)

References 20 publications

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“…In follow-up monitoring, we identified six patients with enophthalmos >2 mm at postoperative Month 12. Past research suggests that this is likely due to intraorbital fat necrosis and atrophy [ 45 ]. Tissue that becomes trapped during pediatric orbital trapdoor fractures is predisposed to obverse necrosis or orbital fat atrophy.…”

Section: Outcomes and Discussionmentioning

confidence: 99%

Theoretical model of pediatric orbital trapdoor fractures and provisional personalized 3D printing-assisted surgical solution

Chai

Zhang

Hua

et al. 2021

Bioactive Materials

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Pediatric orbital trapdoor fractures are common in children and adolescents and usually require emergency surgical intervention. Herein, a personalized 3D printing-assisted approach to surgical treatment is proposed, serving to accurately and effectively repair pediatric orbital trapdoor fractures. We first investigated stress distribution in external force-induced orbital blowout fractures via numerical simulation, determining that maximum stresses on inferior and medial walls exceed those on superior and lateral walls and thus confer higher probability of fracture. We also examined 36 pediatric patients treated for orbital trapdoor fractures between 2014 and 2019 to verify our theoretical construct. Using 3D printing technique, we then created orbital models based on computed tomography (CT) studies of these patients. Absorbable implants were tailor-made, replicating those of 3D-printed models during surgical repairs of fractured orbital bones. As follow-up, we compared CT images and clinical parameters (extraocular movements, diplopia, enophthalmos) before and 12 months after operative procedures. There were only two patients with diplopia and six with enophthalmos >2 mm at 12 months, attesting to the efficacy of our novel 3D printing-assisted strategy.

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Section: Outcomes and Discussionmentioning

confidence: 99%

Theoretical model of pediatric orbital trapdoor fractures and provisional personalized 3D printing-assisted surgical solution

Chai

Zhang

Hua

et al. 2021

Bioactive Materials

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show abstract

“…The fracture extent has a positive correlation with soft tissue impairment. Kim et al [11] emphasized the significance of preoperatively herniated soft tissue in late enophtalmos instead of fracture size. In addition, other studies [5, 9, 10] have described orbital fat scarring and atrophy as a source for enophtalmos.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to volume increase, the role of soft tissue prolapse and soft tissue damage in GMP has been elucidated. Orbital fat scar formation in the retrobulbar space and fat atrophy has been described [5, 9–11]. Furthermore, soft tissue changes and size of the primary fracture area have been shown to predict postoperative enophtalmos independent of surgery [12].…”

Section: Introductionmentioning

confidence: 99%

Does postoperative orbital volume predict postoperative globe malposition after blow-out fracture reconstruction? A 6-month clinical follow-up study

Snäll

Narjus-Sterba

Toivari

et al. 2019

Oral Maxillofac Surg

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Purpose The aim of this study was to investigate the relationship between intraorbital volume change caused by orbital fracture and globe malposition (GMP) in blow-out fracture patients undergoing surgery and to clarify the significance of different radiologically detected predictors associated with GMP. Patients and methods A 6-month prospective follow-up study of unilateral isolated orbital fractures was designed and implemented. The main outcome variable was GMP (present or absent); the secondary outcome was orientation of GMP (horizontal or vertical). The primary predictor variable was postoperative orbital volume difference determined as the difference between the fractured and non-fractured orbit (measured in milliliter and analyzed in milliliter and percentages). The explanatory variables were gender, age, treatment delay from trauma to surgery, fracture site, horizontal depth of the fracture, fracture area, maximum vertical dislocation of the fracture, and preoperative volume difference. Results A total of 15 patients fulfilled the inclusion criteria and were followed for 6 months from a larger cohort. GMP was detected in 6/15 patients (40.0%). GMP was more often present in large (≥ 2.5 cm 2 ) fractures (55.6%), in combined orbital fractures (50.0%), and in fractures with preoperative volume difference ≥ 2.5 ml (62.5%) regardless of the postoperative volume correction. Postoperatively, patients with and without GMP displayed overcorrection of orbital volume; 4.15% corresponded to 1.15 ml (with GMP) and 7.6% corresponded to 1.9 ml (without GMP). Conclusion GMP was present in large and combined orbital fractures. Clinically detectable postoperative GMP occurred despite satisfactory orbital reconstruction and overcorrection. Mild GMP, however, is not significant for the patient.

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“…We were interested to read the article by Kim and colleagues (1). The purpose of the authors was to predict development of late enophthalmos in pure blowout fractures (1).…”

Section: Development Of Late Enophthalmos In Pure Blowout Fractures: mentioning

confidence: 99%

“…We were interested to read the article by Kim and colleagues (1). The purpose of the authors was to predict development of late enophthalmos in pure blowout fractures (1). Several factors influence the development of late enophthalmos, including bony defect size, volume of displaced soft tissue, number of fracture sites, involvement of floor, soft tissue incarceration through the bony defect, and patient age.…”

Section: Development Of Late Enophthalmos In Pure Blowout Fractures: mentioning

confidence: 99%

Development of late enophthalmos in pure blowout fractures: methodologic issues in prediction studies

Sabour

Ghassemi

2017

European Journal of Ophthalmology

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Prediction of the Development of Late Enophthalmos in Pure Blowout Fractures: Delayed Orbital Tissue Atrophy Plays a Major Role

Cited by 24 publications

References 20 publications

Theoretical model of pediatric orbital trapdoor fractures and provisional personalized 3D printing-assisted surgical solution

Theoretical model of pediatric orbital trapdoor fractures and provisional personalized 3D printing-assisted surgical solution

Does postoperative orbital volume predict postoperative globe malposition after blow-out fracture reconstruction? A 6-month clinical follow-up study

Development of late enophthalmos in pure blowout fractures: methodologic issues in prediction studies

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