Shah Kesha, Thakurani Sangeeta
Plastic and Reconstructive Surgery, Sawai Man Singh Medical College, Jaipur, IND.
Cureus. 2024 Sep 27;16(9):e70324. doi: 10.7759/cureus.70324. eCollection 2024 Sep.
Background Orbital reconstruction aims to restore the original orbit volume and correct diplopia, enophthalmos, and ocular motility of the fractured orbit. This study aimed to assess the adequacy of orbital reconstruction using radiological and clinical factors. Methods In this retrospective study, patients with orbital blowout fractures meeting clinical or radiographic criteria underwent orbital reconstruction with titanium mesh. The orbital volume and anteroposterior displacement were calculated pre- and post-operatively using computed tomography. Diplopia, inferior orbital nerve examination, and ocular movement were also evaluated. Pre- and post-operative orbital volumes of the fractured and contralateral unfractured orbits were compared. Statistical analysis was performed using MS Excel (Redmond, USA) and STATA BE (Texas, US). Results There was a significant reduction in the difference in volumes between fractured and normal orbits postoperatively (p-value <0.001). The mean difference between the reconstructed orbital floor fracture and the contralateral normal orbit was 0.55 cm, which is within the normal anatomic variation. Enophthalmos was corrected postoperatively in our patients per radiological parameters as a result of a reduction in the mean posterior displacement. Infraorbital nerve hypoesthesia was not resolved postoperatively. Conclusion Our study highlights the restoration of the normal anatomical variation in volume differences between the fractured and contralateral orbits post-surgery using CT-guided analysis, thereby improving clinical outcomes.
背景 眼眶重建旨在恢复原始眼眶容积，并纠正眼眶骨折后的复视、眼球内陷和眼球运动障碍。本研究旨在利用影像学和临床因素评估眼眶重建的充分性。方法 在这项回顾性研究中，符合临床或影像学标准的眼眶爆裂骨折患者接受了钛网眼眶重建。术前和术后使用计算机断层扫描计算眼眶容积和前后移位。还评估了复视、眶下神经检查和眼球运动。比较骨折眼眶和对侧未骨折眼眶的术前和术后眼眶容积。使用MS Excel（美国雷德蒙德）和STATA BE（美国得克萨斯）进行统计分析。结果 术后骨折眼眶与正常眼眶之间的容积差异显著减小（p值<0.001）。重建的眶底骨折与对侧正常眼眶之间的平均差异为0.55 cm，在正常解剖变异范围内。根据影像学参数，由于平均后移减少，患者术后眼球内陷得到纠正。术后眶下神经感觉减退未得到解决。结论 我们的研究强调了使用CT引导分析在术后恢复骨折眼眶与对侧眼眶之间容积差异的正常解剖变异，从而改善临床结果。
