HSC Section 3 - Trauma, Critical Care and Sleep Medicine

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5. Conclusion

Goggin J, Jupiter DC, Czerwinski M: Simple computed tomography-based calcula- tions of orbital fl oor fracture defect size are not suf fi ciently accurate for clinical use. J Oral Maxillofac Surg 73: 112 e 116 , 2015 Jaquiery C, Aeppli C, Cornelius P, Palmowsky A, Kunz C, Hammer B: Reconstruction of orbital wall defects: critical review of 72 patients. Int J Oral Maxillofac Surg 36: 193 e 199 , 2007 Jin HR, Shin SO, Choo MJ, Choi YS: Relationship between the extent of fracture and the degree of enophthalmos in isolated blowout fractures of the medial orbital wall. J Oral Maxillofac Surg 58: 617 e 620 , 2000 discussion 620 e 611 Kunz C, Sigron GR, Jaquiery C: Functional outcome after non-surgical management of orbital fractures d the bias of decision-making according to size of defect: critical review of 48 patients. Br J Oral Maxillofac Surg 51: 486 e 492 , 2013 Manson PN, Grivas A, Rosenbaum A, Vannier M, Zinreich J, Iliff N: Studies on enophthalmos: II. The measurement of orbital injuries and their treatment by quantitative computed tomography. Plast Reconstr Surg 77: 203 e 214 , 1986 Parbhu KC, Galler KE, Li C, Mawn LA: Underestimation of soft tissue entrapment by computed tomography in orbital fl oor fractures in the pediatric population. Ophthalmology 115: 1620 e 1625 , 2008 Ploder O, Klug C, Voracek M, Backfrieder W, Tschabitscher M, Czerny C, et al: A computer-based method for calculation of orbital fl oor fractures from coronal computed tomography scans. J Oral Maxillofac Surg 59: 1437 e 1442 , 2001 Ploder O, Klug C, Voracek M, Burggasser G, Czerny C: Evaluation of computer-based area and volume measurement from coronal computed tomography scans in isolated blowout fractures of the orbital fl oor. J Oral Maxillofac Surg 60: 1267 e 1272 , 2002 discussion 1273 e 1264 Schouman T, Courvoisier DS, Imholz B, Van Issum C, Scolozzi P: Computational area measurement of orbital fl oor fractures: reliability, accuracy and rapidity. Eur J Radiol 81: 2251 e 2254 , 2012a Schouman T, Courvoisier DS, Van Issum C, Terzic A, Scolozzi P: Can systematic computed tomographic scan assessment predict treatment decision in pure orbital fl oor blowout fractures? J Oral Maxillofac Surg 70: 1627 e 1632 , 2012b Shah HA, Shipchandler TZ, Sufyan AS, Nunery WR, Lee HB: Use of fracture size and soft tissue herniation on computed tomography to predict diplopia in isolated orbital fl oor fractures. Am J Otolaryngol 34: 695 e 698 , 2013 Tahernia A, Erdmann D, Follmar K, Mukundan S, Grimes J, Marcus JR: Clinical im- plications of orbital volume change in the management of isolated and zygo- maticomaxillary complex-associated orbital fl oor injuries. Plast Reconstr Surg 123: 968 e 975 , 2009 Tahiri Y, Lee J, Tahiri M, Sinno H, Williams BH, Lessard L, et al: Preoperative diplopia: the most important prognostic factor for diplopia after surgical repair of pure orbital blowout fracture. J Craniofac Surg 21: 1038 e 1041 , 2010 Whitehouse RW, Batterbury M, Jackson A, Noble JL: Prediction of enophthalmos by computed tomography after 'blow out' orbital fracture. Br J Ophthalmol 78: 618 e 620 , 1994

To date, no prospective study exists that takes into account preoperative ophthalmological symptoms in correlation with CT- morphological assessment. A comparison of borderline IOFF cases with operative and non-surgical management in a randomised controlled study would provide evidence-based data for treatment decision making. The ophthalmological assessment in this study was performed immediately after hospital admission. However, the timespan between trauma and presentation to the hospital was between 2 h and 12 days. This is a determining factor, which has to be addressed in a randomized controlled trial. The proposed pa- rameters, used in a readily accessible and easy-to-evaluate scheme, might help to identify patients in need of surgical intervention. Funding This research did not receive any speci fi c grant from funding agencies in the public, commercial, or not-for-pro fi t sectors. Alinasab B, Beckman MO, Pansell T, Abdi S, Westermark AH, Stjarne P: Relative difference in orbital volume as an indication for surgical reconstruction in isolated orbital fl oor fractures. Craniomaxillofac Trauma Reconstr 4: 203 e 212 , 2011 Burnstine MA: Clinical recommendations for repair of orbital facial fractures. Curr Opin Ophthalmol 14: 236 e 240 , 2003 Cole P, Boyd V, Banerji S, Hollier Jr LH: Comprehensive management of orbital fractures. Plast Reconstr Surg 120: 57S e 63S , 2007 Ellis 3rd E, el-Attar A, Moos KF: An analysis of 2,067 cases of zygomatico-orbital fracture. J Oral Maxillofac Surg 43: 417 e 428 , 1985 Furuta M, Yago K, Iida T: Correlation between ocular motility and evaluation of computed tomography in orbital blowout fracture. Am J Ophthalmol 142: 1019 e 1025 , 2006 Gilbard SM, Mafee MF, Lagouros PA, Langer BG: Orbital blowout fractures. The prognostic signi fi cance of computed tomography. Ophthalmology 92: 1523 e 1528 , 1985 References

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