CC BY-NC 4.0 · Arch Plast Surg 2016; 43(06): 518-522
DOI: 10.5999/aps.2016.43.6.518
Original Article

The Correlation between the Orbital Volume Ratio and Enophthalmos in Unoperated Blowout Fractures

Su Hyun Choi
Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
,
Dong Hee Kang
Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
,
Ja Hea Gu
Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
› Author Affiliations

Background Enophthalmos may not appear immediately after trauma due to periorbital swelling in a blowout fracture, and preoperative measurements of enophthalmos cannot be used as a reliable guideline. It is important to predict the eventual final extent of enophthalmos in order to determine whether to perform surgery, and there have been several attempts to predict the degree of late enophthalmos using preoperative orbital volume. The purpose of this study is to investigate the correlation between the orbital volume ratio (OVR) with final enophthalmos and the palpebral fissure, and to find the OVR that induced 2 mm of enophthalmos in unilateral unoperated blowout fractures.

Methods We retrospectively reviewed the medical records of 38 patients and divided them into 3 groups, determined by the fracture location. The relationships between the OVR and both the degree of enophthalmos and the palpebral fissure ratio (PFR) were assessed and, in particular, the OVR that induced 2 mm of enophthalmos was sought.

Results Enophthalmos increased in proportion to the OVR, and there was a highly significant correlation between the increase in the OVR and the degree of enophthalmos (P<0.05). On the other hand, there was no correlation between OVR and PFR (P>0.05). The OVR that induced 2-mm enophthalmos was 112.18%.

Conclusions The final degree of enophthalmos can be estimated by the preoperative measurement of OVR. Preoperative measurements of OVR can be used as quantitative values to predict the final degree of enophthalmos in pure blowout fractures.

This article was presented at the 72nd Congress of the Korean Society of Plastic and Reconstructive Surgeons, on November 7, 2014 in Seoul, Republic of Korea.




Publication History

Received: 12 April 2016

Accepted: 18 October 2016

Article published online:
20 April 2022

© 2016. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • References

  • 1 Rodriguez ED, Dorafshar AH, Manson PN. Facial fractures. In: Neligan PC, Rodriguez ED, Losee JE. Plastic surgery. Philadelphia: Elsevier Saunders; 2013: 49-88
  • 2 Whitehouse RW, Batterbury M, Jackson A. et al. Prediction of enophthalmos by computed tomography after ‘blow out’ orbital fracture. Br J Ophthalmol 1994; 78: 618-620
  • 3 Ahn HB, Ryu WY, Yoo KW. et al. Prediction of enophthalmos by computer-based volume measurement of orbital fractures in a Korean population. Ophthal Plast Reconstr Surg 2008; 24: 36-39
  • 4 Fan X, Li J, Zhu J. et al. Computer-assisted orbital volume measurement in the surgical correction of late enophthalmos caused by blowout fractures. Ophthal Plast Reconstr Surg 2003; 19: 207-211
  • 5 Raskin EM, Millman AL, Lubkin V. et al. Prediction of late enophthalmos by volumetric analysis of orbital fractures. Ophthal Plast Reconstr Surg 1998; 14: 19-26
  • 6 Gart MS, Gosain AK. Evidence-based medicine: orbital floor fractures. Plast Reconstr Surg 2014; 134: 1345-1355
  • 7 Sung YS, Chung CM, Hong IP. The correlation between the degree of enophthalmos and the extent of fracture in medial orbital wall fracture left untreated for over six months: a retrospective analysis of 81 cases at a single institution. Arch Plast Surg 2013; 40: 335-340
  • 8 Koo L, Hatton MP, Rubin PA. When is enophthalmos “significant”?. Ophthal Plast Reconstr Surg 2006; 22: 274-277
  • 9 Oh SA, Aum JH, Kang DH. et al. Change of the orbital volume ratio in pure blow-out fractures depending on fracture location. J Craniofac Surg 2013; 24: 1083-1087
  • 10 Kwon J, Barrera JE, Jung TY. et al. Measurements of orbital volume change using computed tomography in isolated orbital blowout fractures. Arch Facial Plast Surg 2009; 11: 395-398
  • 11 Mazock JB, Schow SR, Triplett RG. Evaluation of ocular changes secondary to blowout fractures. J Oral Maxillofac Surg 2004; 62: 1298-1302
  • 12 Saiepour D, Messo E, Hedlund AJ. et al. Radiologic and long-term clinical outcome from treatment of isolated medial orbital wall blowout fractures. J Craniofac Surg 2012; 23: 1252-1255
  • 13 Jo A, Rizen V, Nikolic V. et al. The role of orbital wall morphological properties and their supporting structures in the etiology of “blow-out” fractures. Surg Radiol Anat 1989; 11: 241-248