Jacobs Sarah Mireles, Sharifi Emile, Wu Lei, Howe Katherine, Le Thao Phuong, Mitsumori Lee, Ching Randal, Jian-Amadi Arash
a Department of Ophthalmology, University of Washington , Seattle , Washington , USA.
b Department of Ophthalmology, University of Alabama Birmingham , Birmingham , Alabama , USA.
Orbit. 2019 Aug;38(4):269-273. doi: 10.1080/01676830.2018.1509097. Epub 2018 Aug 20.
Orbital blowout fractures result from trauma which breaks the bony orbital wall while sparing the rim. Previous research into fracture mechanism has focused on bony anatomy. This study evaluates the role of preorbital and intraorbital soft tissue volume in fracture risk. A retrospective case-control study was conducted on 51 cases of adults with unilateral orbital blowout fracture, matched to 51 controls who had experienced orbital trauma by comparable mechanisms without sustaining a fracture. Axial Computed Tomography (CT) images with orbital fine cuts were assessed on a 3D post-processing workstation to measure the volume of the pre- and intraorbital soft tissues, then compared between the two groups using Mann-Whitney analysis. In the case group, there were 40 males (78%), injured by assault (66%), fall (12%), motor vehicle collision (10%), or other cause (12%). The control group included 33 males (65%), injured by assault (55%), fall (22%), motor vehicle (4%), or other cause (20%). There was no significant difference in mechanism rates between case and control groups. Median preorbital volumes were 12.5 cm in the case group and14.1 cm in controls ( 0.02). Median intraorbital volumes were 24.4 cm in the case group and 25.9 cm in controls ( = 0.003). CT volumetric analysis shows that patients who sustained blowout fractures have lower preorbital and intraorbital soft tissue volume than those who did not fracture. This underscores the significant role that soft tissues play in dissipating impact forces, both anterior to the orbital rim and within the orbit itself.
眼眶爆裂性骨折是由外伤导致眶壁骨质断裂而眶缘未受损引起的。以往对骨折机制的研究主要集中在骨骼解剖结构上。本研究评估眶前和眶内软组织体积在骨折风险中的作用。对51例单侧眼眶爆裂性骨折的成年患者进行了一项回顾性病例对照研究，匹配51例通过类似机制遭受眼眶外伤但未发生骨折的对照者。在三维后处理工作站上评估带有眼眶薄层扫描的轴向计算机断层扫描（CT）图像，以测量眶前和眶内软组织的体积，然后使用曼-惠特尼分析在两组之间进行比较。病例组中有40名男性（78%），受伤原因包括袭击（66%）、跌倒（12%）、机动车碰撞（10%）或其他原因（12%）。对照组包括33名男性（65%），受伤原因包括袭击（55%）、跌倒（22%）、机动车（4%）或其他原因（20%）。病例组和对照组在受伤机制发生率上没有显著差异。病例组眶前体积中位数为12.5cm³，对照组为14.1cm³（P = 0.02）。病例组眶内体积中位数为24.4cm³，对照组为25.9cm³（P = 0.003）。CT容积分析表明，发生爆裂性骨折的患者眶前和眶内软组织体积低于未骨折患者。这突出了软组织在消散眶缘前方和眶内冲击力方面所起的重要作用。
