Maxillofacial Plastic and Reconstructive Surgery

  • 제36권6호
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  • Pages.273-279
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  • 2014
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  • 2288-8101(pISSN)
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  • 2288-8586(eISSN)
대한악안면성형재건외과학회 (Korean Association of Maxillofacial Plastic and Reconstructive Surgeons)
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Effectiveness of Computed Tomography for Blow-out Fracture

  • Rhee, Seung-Hyun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Kim, Tae-Seup (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Song, Jae-Min (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Shin, Sang-Hoon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Lee, Jae-Yeol (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University)
  • 투고 : 2014.09.25
  • 심사 : 2014.10.29
  • 발행 : 2014.11.30
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초록

Purpose: This study assessed the association between eye symptoms (enophthalmos or diplopia) and site of damage, volume, deviated inferior rectus muscle (IRM) and type of fracture with computed tomography (CT). The intent is to anticipate the prognosis of orbital trauma at initial diagnosis. Methods: Forty-five patients were diagnosed with fractures of the inferior wall of one orbit. Fracture area, volume of displaced tissue, deviated IRM, and type of fracture were evaluated from coronal CT by one investigator. The association of those variables with the occurrence of eye symptoms (diplopia and enophthalmos) was assessed. Results: Of 45 patients, 27 were symptom-free (Group A) and 18 had symptoms (Group B) of enophthalmos and/or diplopia. In Group B, 12 had diplopia, one was enophthalmos, and five had both. By CT measurement, group A mean area was $192.6mm^2$ and the mean volume was $673.2mm^3$. Group B area was $316.2mm^2$ and volume was $1,710.6mm^3$. The volume was more influential on symptom occurrence. Each patient was categorized into four grades depending on the location of IRM. Symptom occurrence and higher grade were associated. Twenty-six patients had trap-door fracture (one side, attached to the fracture), and 19 had punched-out fracture (both sides detached). The punched-out fracture was more strongly associated with symptoms and had statistically significantly higher area and volume. Conclusion: In orbital trauma, measurement of fracture area and volume, evaluation of the deviated IRM and classification of the fracture type by coronal CT can effectively predict prognosis and surgical indication.

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참고문헌

  1. Kelley P, Crawford M, Higuera S, Hollier LH. Two hundred ninety-four consecutive facial fractures in an urban trauma center: lessons learned. Plast Reconstr Surg 2005;116:42e-9e. https://doi.org/10.1097/01.prs.0000177687.83247.27
  2. Cheong EC, Chen CT, Chen YR. Broad application of the endoscope for orbital floor reconstruction: long-term follow-up results. Plast Reconstr Surg 2010;125:969-78. https://doi.org/10.1097/PRS.0b013e3181cb64b2
  3. Kim HG, Son YH, Chung IK. Facial bone fracture patients visiting Pusan National University Hospital in Busan and Yangsan: trends and risks. Maxillofac Plast Reconstr Surg 2014;36:140-5. https://doi.org/10.14402/jkamprs.2014.36.4.140
  4. Gosse EM, Ferguson AW, Lymburn EG, Gilmour C, MacEwen CJ. Blow-out fractures: patterns of ocular motility and effect of surgical repair. Br J Oral Maxillofac Surg 2010;48:40-3. https://doi.org/10.1016/j.bjoms.2009.04.028
  5. Manson PN, Grivas A, Rosenbaum A, Vannier M, Zinreich J, Iliff N. Studies on enophthalmos: ii. The measurement of orbital injuries and their treatment by quantitative computed tomography. Plast Reconstr Surg 1986;77:203-14. https://doi.org/10.1097/00006534-198602000-00005
  6. Jang HS, Leem DH, Baek JA, Shin HK, Ko SO. Degree of enophthalmos according to the extent of orbital wall fracture and volume of herniated orbital tissue. J Korean Assoc Oral Maxillofac Surg 2011;37:205-13. https://doi.org/10.5125/jkaoms.2011.37.3.205
  7. Jeon J, Chon KM, Jung TY, Noh WJ, Kwon JH, Kim YH. Relationship between degree of enophthalmos and orbital volume measured with computed tomography in isolated blowout fractures of the orbit. Korean J Otorhinolaryngol-Head Neck Surg 2009;52:810-5. https://doi.org/10.3342/kjorl-hns.2009.52.10.810
  8. Ploder O, Klug C, Voracek M, Burggasser G, Czerny C. Evaluation of computer-based area and volume measurement from coronal computed tomography scans in isolated blowout fractures of the orbital floor. J Oral Maxillofac Surg 2002;60:1267-72. https://doi.org/10.1053/joms.2002.35722
  9. Schouman T, Courvoisier DS, Van Issum C, Terzic A, Scolozzi P. Can systematic computed tomographic scan assessment predict treatment decision in pure orbital floor blowout fractures? J Oral Maxillofac Surg 2012;70:1627-32. https://doi.org/10.1016/j.joms.2012.03.006
  10. Hammer B, Prein J. Correction of post-traumatic orbital deformities: operative techniques and review of 26 patients. J Craniomaxillofac Surg 1995;23:81-90. https://doi.org/10.1016/S1010-5182(05)80453-6
  11. Dutton JJ. Management of blow-out fractures of the orbital floor. Surv Ophthalmol 1991;35:279-80. https://doi.org/10.1016/0039-6257(91)90048-K
  12. Dulley B, Fells P. Long-term follow-up of orbital blow-out fractures with and without surgery. Mod Probl Ophthalmol 1975;14:467-70.
  13. Osguthorpe JD. Orbital wall fractures: evaluation and management. Otolaryngol Head Neck Surg 1991;105:702-7. https://doi.org/10.1177/019459989110500511
  14. Hawes MJ, Dortzbach RK. Surgery on orbital floor fractures. Influence of time of repair and fracture size. Ophthalmology 1983;90:1066-70. https://doi.org/10.1016/S0161-6420(83)80049-9
  15. Jin HR, Shin SO, Choo MJ, Choi YS. Relationship between the extent of fracture and the degree of enophthalmos in isolated blowout fractures of the medial orbital wall. J Oral Maxillofac Surg 2000;58:617-20. https://doi.org/10.1016/S0278-2391(00)90152-6
  16. Parsons GS, Mathog RH. Orbital wall and volume relationships. Arch Otolaryngol Head Neck Surg 1988;114:743-7. https://doi.org/10.1001/archotol.1988.01860190047020
  17. Thaller-Antlanger H. Orbital wall fracture from the ophthalmologic viewpoint. Ther Umsch 1990;47:279-88.

피인용 문헌

  1. Correlation between the 2-Dimensional Extent of Orbital Defects and the 3-Dimensional Volume of Herniated Orbital Content in Patients with Isolated Orbital Wall Fractures vol.44, pp.1, 2017, https://doi.org/10.5999/aps.2017.44.1.26
  2. The role of computed tomography (CT) in predicting diplopia in orbital blowout fractures (BOFs) pp.1438-1435, 2018, https://doi.org/10.1007/s10140-017-1551-1
  3. New anthropometric data for preoperative planning in orbital wall fracture treatment: the use of eyelid drooping vol.19, pp.4, 2018, https://doi.org/10.7181/acfs.2018.02096