Computational area measurement of orbital floor fractures: Reliability, accuracy and rapidity

Can a Specific Computed Tomography-Based Assessment Predict the Ophthalmological Outcome in Pure Orbital Floor Blowout Fractures?

“…Previous studies showed their high accuracy, reliability, and reproducibility. 9,10 The RF was known to be correlated with the degree of enophthalmos during the initial phase of trauma, especially if the bone defect was in the posterior orbital cone. 3,10,22 Contrary to previous studies that showed no association between fracture size and long-term clinical outcome, a significant correlation emerged in our study between RF and the severity of enophthalmos after 6 months, independently of surgical correction.…”

“…However, the sample size was comparable to, To our knowledge, this is the first study of its kind to take into account reproducible, validated CT parameters. 9,10 Our description of long-term sequelae included not only persistent clinical disorders, such as diplopia or severe enophthalmos (!2 mm), but also subclinical disorders detected through a detailed orthoptic examination. We thus included analysis of mild enophthalmos (2 mm) and ocular motility restrictions that were not accompanied by clinical diplopia.…”

“…For each patient, the following 3 parameters were calculated according to the computational method previously described and validated by Schouman et al 9,10 (1) Area ratio of the fractured orbital floor (RF ¼ fracture area/ total orbital floor area) (Fig. 1).…”

“…Multiple radiologic diagnostic criteria developed using computed tomography (CT) have tried to establish the relationships between the images observed and the associated clinical signs and symptoms. [3][4][5][6][7][8][9][10] Some of these criteria have already demonstrated their utility and reliability for a therapeutic decision-making strategy for pure BOFs. 6,10 Studies have been mainly focused on the prevalence of diplopia in patients with BOFs, the possible association between orbital volume and severity of enophthalmos development and the possible beneficial effect of surgical treatment on the functional status of ocular motility.…”

The significance of orbital floor exploration during open reduction of zygomaticomaxillary complex fractures

“…The orbital volume can be assessed through high-resolution biplanar CT scans, invaluable for decision making in the management of enophthalmos. Furthermore, cone beam CT (CBCT) and especially coronal views, may help in revealing orbital defects, through detection of herniated orbital contents 2,5,[9][10][11] . Despite the multiple sophisticated imaging modalities and meticulous clinical examination, orbital floor defects associated with ZMC fractures may evade diagnosis and appropriate management.…”