Kovar Daniel, Voldrich Zdenek, Voska Pavel, Lestak Jan, Astl Jaromir
Department of ENT and Maxillofacial surgery, 3rd Faculty of Medicine, Charles University in Prague and Military University Hospital Prague, Czech Republic.
Faculty of Military Health Science in Hradec Kralove, University of Defence, Hradec Kralove, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2017 Dec;161(4):403-406. doi: 10.5507/bp.2017.036. Epub 2017 Aug 31.
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.
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.
According to the proposed model, posterior and anterior fractures with a prolapse volume above 500 mm, and anteroposterior fractures with a volume over 1400 mm, are indicated for surgery.
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.
耳鼻喉科医生经常会遇到眶底骨折的情况。最严重的并发症是复视，这是由于眶内容物疝出导致的，无论有无下直肌固定。我们这项工作的目的是创建一个数学模型，用于计算爆裂性骨折中眶内脱垂软组织的体积，以此作为决定是否需要手术治疗的一个因素。
在一项回顾性研究（2007 - 2013年）中，我们评估了80例爆裂性骨折患者，将其分为两组，每组40例：40例接受保守治疗，40例接受手术治疗。我们通过测量CT图像冠状面和矢状面的骨折线及眶软组织疝出情况来创建模型，该模型相当于一个旋转椭球体体积的一半。
根据所提出的模型，脱垂体积超过500立方毫米的前后位骨折以及体积超过1400立方毫米前后位骨折，建议进行手术。
相对于骨折位置的脱垂软组织体积是受伤后立即选择最佳治疗方案的主要指标。
