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Radiologic and Long-Term Clinical Outcome From Treatment of Isolated Medial Orbital Wall Blowout Fractures
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
2012 (English)In: The Journal of craniofacial surgery (Print), ISSN 1049-2275, E-ISSN 1536-3732, Vol. 23, no 5, 1252-1255 p.Article in journal (Refereed) Published
Abstract [en]

Blowout fractures in the medial orbital wall may lead to enophthalmos, ocular dysmotility, and diplopia. Ten consecutive patients with unilateral, isolated fractures of the medial orbital wall were retrospectively studied. The radiologic accuracy of the medial orbital wall reconstructions and the long-term clinical outcomes were assessed. All cases were treated through a bicoronal approach and by use of porous polyethylene-titanium implants. The total fracture area and the orbital volume increase from the blowout were measured on computed tomographic scans. Next, we evaluated the reconstruction in the posterior part of the medial wall. This was done by calculating the ratio between the defect area and the implant area located behind the anterior ethmoidal canal. The patients were examined at least 1 year after the operation, and the rates of enophthalmos and diplopia were evaluated. The mean fracture defect area was 2.45 cm(2) (range, 0.41-4.16 cm(2)), and the mean volume increase from the blowout fractures was 1.82 cm(3) (range, 0.53-2.76 cm(3)). The orbital volume was accurately restored in all patients. However, the ratio of implant to defect area behind the anterior ethmoidal canal ranged from 0% to 100% (mean, 47.3%). None of the patients had enophthalmos or diplopia at the long-term follow-up. The results confirm that restoration of orbital volume is important to prevent postoperative enophthalmos in isolated medial orbital blowout fractures. Complete reconstruction of the most posterior part of the medial orbital wall seems to be of lesser importance.

Place, publisher, year, edition, pages
2012. Vol. 23, no 5, 1252-1255 p.
Keyword [en]
Orbit, facial fracture
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-185649DOI: 10.1097/SCS.0b013e31825e4e8eISI: 000309547200064OAI: oai:DiVA.org:uu-185649DiVA: diva2:572317
Available from: 2012-11-27 Created: 2012-11-27 Last updated: 2017-12-07Bibliographically approved

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Saiepour, DanielMesso, EliasHedlund, Anders J. O.Nowinski, Daniel J.

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