Effectiveness of Computed Tomography for Blow-out Fracture
이승현, Kim Tae-Seup, 송재민, 신상훈, 이재열,
소속 상세정보
이승현 ( Rhee Seung-Hyun ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
( Kim Tae-Seup ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
송재민 ( Song Jae-Min ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
신상훈 ( Shin Sang-Hoon ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
이재열 ( Lee Jae-Yeol ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
KMID : 1036320140360060273
Abstract
Purpose: This study assessed the association between eye symptoms (enophthalmos or diplopia) and site of damage, volume, deviated inferior rectus muscle (IRM) and type of fracture with computed tomography (CT). The intent is to anticipate the prognosis of orbital trauma at initial diagnosis.
Methods: Forty-five patients were diagnosed with fractures of the inferior wall of one orbit. Fracture area, volume of displaced tissue, deviated IRM, and type of fracture were evaluated from coronal CT by one investigator. The association of those variables with the occurrence of eye symptoms (diplopia and enophthalmos) was assessed.
Results: Of 45 patients, 27 were symptom-free (Group A) and 18 had symptoms (Group B) of enophthalmos and/or diplopia. In Group B, 12 had diplopia, one was enophthalmos, and five had both. By CT measurement, group A mean area was 192.6 mm2 and the mean volume was 673.2 mm3. Group B area was 316.2 mm2 and volume was 1,710.6 mm3. The volume was more influential on symptom occurrence. Each patient was categorized into four grades depending on the location of IRM. Symptom occurrence and higher grade were associated. Twenty-six patients had trap-door fracture (one side, attached to the fracture), and 19 had punched-out fracture (both sides detached). The punched-out fracture was more strongly associated with symptoms and had statistically significantly higher area and volume.
Conclusion: In orbital trauma, measurement of fracture area and volume, evaluation of the deviated IRM and classification of the fracture type by coronal CT can effectively predict prognosis and surgical indication.
키워드
Orbital injury; Blow-out fractures; Computed tomography; Volume measurement
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