Evaluation of a computed-tomography-based assessment scheme in treatment decision-making for isolated orbital floor fractures |
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| Authors: | Gesche Frohwitter Stephan Wimmer Carolin Goetz Jochen Weitz Michael Ulbig Karsten U. Kortuem Julia Dangelmaier Lucas Ritschl Christian Doll Oliver Ristow Marco R. Kesting Steffen Koerdt |
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| Affiliation: | 1. Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University, Glückstrasse 11, D-91054, Erlangen, Germany;2. Department of Oral and Maxillofacial Surgery, Technical University of Munich (TUM), Ismaninger Str. 22, D-81675, Munich, Germany;3. Department of Ophthalmology, Technical University of Munich (TUM), Ismaninger Str. 22, D-81675, Munich, Germany;4. Moorfields Eye Hospital, NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK;5. University Eye Hospital Munich, Ludwig-Maximilians-University (LMU), Mathildenstr. 8, D-80336, Munich, Germany;6. Department of Diagnostic and Interventional Radiology, Technical University of Munich (TUM), Ismaninger Str. 22, D-81675, Munich, Germany;g. Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Germany;h. Department of Oral and Maxillofacial Surgery, Ruprecht-Karls-University, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany |
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| Abstract: | ![]()
IntroductionTreatment decisions for fractures of the orbital floor are based on clinical appearance, ophthalmological examination, and computed tomography (CT) scans. In extensive fractures, decisions are easily made between conservative and surgical treatment. However, objective parameters are rare in inconclusive cases.Materials and methodsOur retrospective study included 106 patients with unilateral isolated orbital floor fractures. Correlations between preoperative ophthalmological examinations and specific CT parameters were performed.ResultsThe defect size of the fracture appeared to be significantly associated with the presence of diplopia. CT-morphological parameters and preoperative ophthalmological results showed statistical significance for diplopia and incarceration of inferior rectus muscle (IRM), diplopia and displacement of IRM, decreased mobility and incarceration of IRM, and decreased mobility and displacement of IRM.DiscussionOur clinical assessment scheme for CT scans of orbital floor fractures is aimed at facilitating treatment decision making using four CT-based variables. As critical size defects of the orbital floor of ≥2 cm2 are likely to cause clinically significant posterior displacement of the globe, resulting in enophthalmos, the proposed parameters offer a readily accessible and easy to evaluate scheme that helps to identify patients in need of surgical intervention. |
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| Keywords: | Orbital floor Midface fracture Computed tomography Diplopia |
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