Abstract
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 mm3, and anteroposterior fractures with a volume over 1400 mm3, 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.
Highlights
The concept of a hydraulic, retromarginal orbital fracture first appeared in the world literature in the work of Smith and Regan[1] in 1957
Orbital injuries make up about 40% of all fractures of the facial skeleton, and 67-84% of these are retromarginal orbital fractures
The resulting volumes of prolapsed orbital soft tissue in conservative and surgical methods of treatment are shown in the tables below (Table 2 and 3)
Summary
The concept of a hydraulic, retromarginal orbital fracture (blow-out fracture) first appeared in the world literature in the work of Smith and Regan[1] in 1957. 1. Following a blunt blow to the flexible, incompressible eyeball, transfer of pressure occurs causing a fracture of the lower and/or medial walls of the orbital floor. 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. 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. 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
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Schedule a callMore From: Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
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