Relationship between the Extent of Fracture and the Degree of Enophthalmos in Isolated Blowout Fracture of the Medial Orbital Wall

Jin, Hong Ryul; Shin, Si Ok; Choo, Moo Jin; Choi, Young Seok; Yang, Sang Kwon; Kim, Jong Wook

Abstract

BACKGROUND AND OBJECTIVES: In blowout fracture (BOF) of the medial orbital wall, the presence of significant enophthalmos indicates a need for surgery. In early post-traumatic period, it is usually difficult to measure the degree of enophthalmos due to orbital edema. So, in order to decide on the correct treatment method, it will be useful if we can predict the degree of enophthalmos according to the extent of fracture observed in computed tomography (CT). We studied the relationship between the extent of fracture measured in CT scans and the degree of enophthalmos in BOF of the medial orbital wall.
MATERIALS AND METHODS
Nine patients with isolated BOF of the medial orbital wall confirmed by CT scans were studied. The severity of enophthalmos was measured by exophthalmometry. The area of fracture site and the volume of herniated orbital tissue were measured in CT scans. The statistical significance was analyzed using linear regression method.
RESULTS
The degree of enophthalmos increased as the area of fracture site or the volume of herniated orbital tissue increased. The area of the fracture site and the volume of the herniated orbital tissue that caused enophthalmos of 2 mm were 1.9 cm2 and 0.9 ml, respectively.
CONCLUSION
In BOF of the medial orbital wall, surgical intervention may be recommended to prevent significant enophthalmos when the area of fracture site is 1.9 cm2 or more, or the volume of herniated orbital tissue is 0.9 ml or more.