Department of Ophthalmology, Union Hospital, Tong Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, China.
Sci Rep. 2023 Nov 27;13(1):20862. doi: 10.1038/s41598-023-47941-9.
This study investigated the orbital morphological features that lead to fractures at different sites by comparing patients with isolated inferior wall fracture (IWF) to patients with isolated medial wall fracture (MWF). This study analyzed the orbital morphologic characteristics of all orbital fracture patients who underwent orbital computed tomography (CT) scans between January 2017 and October 2022. On CT scans, the bony structures of the orbit were measured. We investigated the bilateral symmetry of orbital. In addition, orbital morphological differences were compared between patients with fractures of the medial wall and those with fractures of the inferior wall. A total of 135 patients with orbital fractures were included in the study. Of these, 91 were isolated MWFs and 44 were isolated IWF. We confirmed the symmetry of bilateral orbits and measured the orbit of the uninjured side. No differences were found between the MWF group and the IWF group in terms of ocular prominence, horizontal orbital diameter, orbital rim angle, sagittal orbital depth, sagittal orbital depth, and angle of inferior wall inclination. The distance between the infraorbital nerve (ION) entry point and the orbital rim was significantly smaller in the inferior lateral wall fracture group than in the MWF group (11.87 ± 2.54 vs 14.90 ± 4.64, P < 0.001), and the percentage of type 1 ION was significantly lower in the IWF group than in the MWF group (40.9% vs 65.9%, P = 0.012). We demonstrated the symmetry of bilateral orbits and found that when the point where the ION enters the infraorbital canal is near the orbital rim, patients are more prone to suffering a fracture of the inferior wall after orbital trauma. It is less likely for patients with type 1 ION to suffer an IWF following an orbital fracture.
本研究通过比较单纯眶下壁骨折（IWF）患者和单纯眶内侧壁骨折（MWF）患者，探讨导致不同部位骨折的眶形态特征。本研究分析了 2017 年 1 月至 2022 年 10 月期间所有接受眼眶计算机断层扫描（CT）检查的眼眶骨折患者的眼眶形态特征。在 CT 扫描中，测量了眼眶的骨结构。我们研究了双侧眼眶的对称性。此外，还比较了内侧壁骨折患者和下壁骨折患者的眼眶形态差异。共纳入 135 例眼眶骨折患者，其中 91 例为单纯 MWF，44 例为单纯 IWF。我们证实了双侧眼眶的对称性，并测量了未受伤侧的眼眶。MWF 组和 IWF 组在眼球突出度、水平眶径、眶缘角、矢状眶深度、矢状眶深度和下壁倾斜角方面无差异。眶下神经（ION）进入点与眶缘之间的距离在下壁外侧壁骨折组明显小于 MWF 组（11.87±2.54 比 14.90±4.64，P<0.001），并且 IWF 组中 ION 类型 1 的比例明显低于 MWF 组（40.9%比 65.9%，P=0.012）。我们证明了双侧眼眶的对称性，并发现当 ION 进入眶下管的点靠近眶缘时，患者在眼眶外伤后更易发生下壁骨折。眼眶骨折后 ION 类型 1 患者发生 IWF 的可能性较小。
