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Prediction of Enophthalmos in Medial Orbital Wall Fracture: Suggested Coordinate Plane for Making Surgical Decisions

Authors
 Young Woong Mo  ;  Da Hye Ryu  ;  Hea Kyeong Shin  ;  Won Jai Lee 
Citation
 JOURNAL OF CRANIOFACIAL SURGERY, Vol.34(4) : 1185-1190, 2023-06 
Journal Title
JOURNAL OF CRANIOFACIAL SURGERY
ISSN
 1049-2275 
Issue Date
2023-06
MeSH
Enophthalmos* / complications ; Enophthalmos* / surgery ; Humans ; Orbit / surgery ; Orbital Fractures* / complications ; Orbital Fractures* / diagnostic imaging ; Orbital Fractures* / surgery ; Retrospective Studies ; Tomography, X-Ray Computed / adverse effects
Abstract
Background: Enophthalmos is one of the most distressing complications of blowout orbital fractures. Although several studies have been conducted on the topic of indications of early surgical correction, none have been performed using a set of measurable parameters.

Methods: The study quantitatively examined orbital fracture areas (OFA) and volumes (OFV) retrospectively of 242 patients with isolated medial orbital wall fractures that were treated conservatively during a 12-year period (from 2009 to 2021). Three plastic surgeons measured enophthalmos >6 months after trauma. The correlations between parameters and enophthalmos in the study cohort were analyzed. In addition, patients treated operatively, and nonoperatively were compared with assess the suitability of the predictive model.

Results: Significant correlations were observed between several parameters and late enophthalmos. Total 2.59 cm 2 of OFA (ie, OFA >2.59 cm 2 ) or 1.45 cm 3 of OFV (ie, OFV >1.45 cm 3 ) corresponds to 2 mm of enophthalmos. Multiple regression analysis revealed the following coefficients: -0.208 is a constant ( P <0.001), with 0.695 and 0.372 for OFA and OFV, respectively ( P <0.001 for both OFA and OFV).

Conclusions: The study shows that enophthalmos can be more accurately predicted when OFA and OFV are simultaneously considered in patients with isolated medial wall fractures. Finally, an algorithm and a "blowout fracture coordinate plane" was proposed to aid treatment decision-making in isolated medial wall fractures.

Copyright © 2023 by Mutaz B. Habal, MD.
Full Text
https://journals.lww.com/jcraniofacialsurgery/fulltext/2023/06000/prediction_of_enophthalmos_in_medial_orbital_wall.9
DOI
10.1097/SCS.0000000000009152
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Mo, Young Woong(모영웅) ORCID logo https://orcid.org/0000-0002-4180-3139
Lee, Won Jai(이원재) ORCID logo https://orcid.org/0000-0003-3056-0503
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/197441
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