J Korean Assoc Oral Maxillofac Surg.  2011 Jun;37(3):205-213. 10.5125/jkaoms.2011.37.3.205.

Degree of enophthalmos according to the extent of orbital wall fracture and volume of herniated orbital tissue

• Jang HS
• Leem DH
• Baek JA
• Shin HK
• Ko SO

• KMID: 2189776
• DOI: http://doi.org/10.5125/jkaoms.2011.37.3.205

Abstract

INTRODUCTION
The enlargement and deformation of the orbit give rise to a visible enophthalmos. As a consequence, a disturbance of eye motility together with double images is likely to occur. This study examined the degree of enophthalmos according to the extent of orbital wall fracture and volume of herniated orbital tissue in blowout fractures of the medial and inferior orbital wall.
MATERIALS AND METHODS
This study was performed on patients diagnosed with medial and inferior orbital wall fractures at the Department of Oral and maxillofacial surgery, Chonbuk National University Hospital from 2007 to 2009. The patients' age, gender, etiology of fracture and degree of enophthalmos were investigated. The changes in the degree of enophthalomos, diplopia and ocular motility restriction after operation were examined.
RESULTS
The degree of enophthalomos increased with increasing extent of orbital wall fracture and volume of herniated orbital tissue.
CONCLUSION
Whether to perform the operation is decided after measuring the extent of the orbital wall fracture and volume of herniated orbital tissue using computed tomography (CT), time for the decision of operation can be shortened. This can cause a decrease in the complications of orbital wall fractures.

Keyword

Orbital wall fracture; Blowout fracture; Enophthalmos; Diplopia; Ocular motility restriction

MeSH Terms

Diplopia
Enophthalmos
Eye
Humans
Orbit
Surgery, Oral

Figure

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  Fig. 1. Enophthalmos measurement. A: Oculus exophthalmometry, B: Enophthalmos measurement method.

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  Fig. 2. The area of fracture site is calculated from measurements on coronal (A, C), axial (B), and sagittal (D) CT scan. a: Height of medial wall fracture, b: Length of medial wall fracture, c: Degree of medial displacement of the herniated orbital tissue, d: Width of inferior wall fracture, e: Length of inferior wall fracture, f: Degree of inferior displacement of the herniated orbital tissue. Area of fracture site – medial wall: π×a/2×b/2, inferior wall: π×d/2×e/2 Volume of herniated orbital tissue – medial wall: π×abc/6, inferior wall: π×def/6

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  Fig. 3. Positive correlation between the area of fracture and the degree of enophthalmos (E*). A: Medial wall fracture, B: Inferior wall fracture.

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  Fig. 4. Positive correlation between the volume of herniated orbital tissue and the degree of enophthalmos (E*). A: Medial wall fracture, B: Inferior wall fracture.

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  Fig. 5. Positive correlation between the area of fracture (medial+inferior) and the degree of enophthalmos (E*).

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  Fig. 6. Positive correlation between the volume of herniated orbital tissue (medial+inferior) and the degree of enophthalmos (E*).

Reference

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