Indications for repositioning of blow-out fractures of the orbital floor based on new objective criteria - tissue protrusion volumometry

Background and Aim. The otolaryngologist often meets with fractures of the orbital floor. The most serious complication is diplopia, arising as a result of herniation of the orbital contents, with or without fixation of the inferior rectus muscle. The aim of our work was to create a mathematical mod...

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Bibliographic Details
Main Authors: Daniel Kovar, Zdenek Voldrich, Pavel Voska, Jan Lestak, Jaromir Astl
Format: Article
Language:English
Published: Palacký University Olomouc, Faculty of Medicine and Dentistry 2017-12-01
Series:Biomedical Papers
Subjects:
Online Access:https://biomed.papers.upol.cz/artkey/bio-201704-0011_Indications_for_repositioning_of_blow-out_fractures_of_the_orbital_floor_based_on_new_objective_criteria_-_tiss.php
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Summary:Background and Aim. The otolaryngologist often meets with fractures of the orbital floor. The most serious complication is diplopia, arising as a result of herniation of the orbital contents, with or without fixation of the inferior rectus muscle. The aim of our work was to create a mathematical model to calculate the volume of prolapsed soft tissue of the orbit in blow-out fractures, as a factor in deciding on the need for surgical treatment. Patients and Methods: In a retrospective study (2007-2013), we evaluated 80 patients with blow-out fractures, divided into two equal groups: 40 conservatively treated and 40 surgically treated patients. We created the model by measuring the fracture lines and herniation of the orbital soft tissues in the coronal and sagittal sections from CT images, equivalent to half the volume of a rotating ellipsoid. Results: According to the proposed model, posterior and anterior fractures with a prolapse volume above 500 mm3, and anteroposterior fractures with a volume over 1400 mm3, are indicated for surgery. Conclusion: The volume of prolapsed soft tissue relative to the location of the fracture is the main indicator for selecting the best treatment procedure immediately after injury.
ISSN:1213-8118
1804-7521