Intraoperative computed tomography to facilitate repair of orbitozygomatic fractures

Abstract

Present-day management of complex orbitozygomatic and large orbital blow-out fractures involves wide exposure to allow for direct inspection of fracture reduction and implant placement. This usually means multiple incisions, and thus prolonged surgical time and expense. Even then, it is not possible to uniformly predict accurate postoperative results. We describe the use of intraoperative computed tomography to immediately evaluate the accuracy of the repairs, thus allowing for revisions, if necessary, at the time of the initial procedure. As the surgical team gains experience with intraoperative scanning, the benefits that should be realized include elimination of the need for wide exposure of all fracture sites, shortened surgical time and expense, and fewer return visits to the operating room for secondary revision procedures. Present-day management of complex orbitozygomatic and large orbital blow-out fractures involves wide exposure to allow for direct inspection of fracture reduction and implant placement. This usually means multiple incisions, and thus prolonged surgical time and expense. Even then, it is not possible to uniformly predict accurate postoperative results. We describe the use of intraoperative computed tomography to immediately evaluate the accuracy of the repairs, thus allowing for revisions, if necessary, at the time of the initial procedure. As the surgical team gains experience with intraoperative scanning, the benefits that should be realized include elimination of the need for wide exposure of all fracture sites, shortened surgical time and expense, and fewer return visits to the operating room for secondary revision procedures.