A1 Refereed original research article in a scientific journal
Does postoperative orbital volume predict postoperative globe malposition after blow-out fracture reconstruction? A 6-month clinical follow-up study
Authors: Snäll J., Narjus-Sterba M., Toivari M., Wilkman T., Thorén H.
Publisher: SPRINGER HEIDELBERG
Publication year: 2019
Journal: Oral and Maxillofacial Surgery
Journal name in source: ORAL AND MAXILLOFACIAL SURGERY-HEIDELBERG
Journal acronym: ORAL MAXILLOFAC SURG
Volume: 23
Issue: 1
First page : 27
Last page: 34
Number of pages: 8
ISSN: 1865-1550
DOI: https://doi.org/10.1007/s10006-019-00748-3
Web address : https://link.springer.com/article/10.1007/s10006-019-00748-3
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/39776605
Purpose: The aim of this study was to investigate the relationship between intraorbital volume change caused by orbital fracture and globe malposition (GMP) in blow-out fracture patients undergoing surgery and to clarify the significance of different radiologically detected predictors associated with GMP.
Patients and methods: A 6-month prospective follow-up study of unilateral isolated orbital fractures was designed and implemented. The main outcome variable was GMP (present or absent); the secondary outcome was orientation of GMP (horizontal or vertical). The primary predictor variable was postoperative orbital volume difference determined as the difference between the fractured and non-fractured orbit (measured in milliliter and analyzed in milliliter and percentages). The explanatory variables were gender, age, treatment delay from trauma to surgery, fracture site, horizontal depth of the fracture, fracture area, maximum vertical dislocation of the fracture, and preoperative volume difference.
Results: A total of 15 patients fulfilled the inclusion criteria and were followed for 6months from a larger cohort. GMP was detected in 6/15 patients (40.0%). GMP was more often present in large (2.5cm(2)) fractures (55.6%), in combined orbital fractures (50.0%), and in fractures with preoperative volume difference 2.5ml (62.5%) regardless of the postoperative volume correction. Postoperatively, patients with and without GMP displayed overcorrection of orbital volume; 4.15% corresponded to 1.15ml (with GMP) and 7.6% corresponded to 1.9ml (without GMP).
Conclusion: GMP was present in large and combined orbital fractures. Clinically detectable postoperative GMP occurred despite satisfactory orbital reconstruction and overcorrection. Mild GMP, however, is not significant for the patient.
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