J Korean Ophthalmol Soc.  2011 Aug;52(8):902-909. 10.3341/jkos.2011.52.8.902.

A Study of Different Aspects of Blowout Fracture Between Preoperative CT and Intraoperative Images

• Ham DS
• Lee CH
• Yang JW

• KMID: 2214765
• DOI: http://doi.org/10.3341/jkos.2011.52.8.902

Abstract

PURPOSE
To analyze the morphologic differences in blowout fracture seen on preoperative CT images compared to intraoperative images.
METHODS
The present study included 63 patients (63 eyes) with orbital fractures that were repaired by orbital reconstruction between January 2009 and April 2010. We assessed the medial, inferior, and inferomedial orbital fractures and excluded superior and lateral wall fractures. We captured intraoperative blowout fracture images using a camera or endoscope and compared the fracture type (fracture size, fracture surface) seen on intraoperative images with that observed on the preoperative CT images.
RESULTS
The study consisted of patients between 20 and 50 years of age with a mean age of 27.76 years (men: 49 eyes, women: 14 eyes). The proportions of small fractures and medium fractures were similar on the preoperative CT images; however, large fractures were observed more frequently on the intraoperative images. The proportions of mono-fragment fractures and multi-fragment fractures were similar on the preoperative CT images, but multi-fragment fractures, especially inferior orbital fractures, were more frequent on the intraoperative images. Features of the trapdoor fracture differed most between images in terms of fracture size and surface.
CONCLUSIONS
The morphology of blowout fractures, especially trapdoor fractures, differed between preoperative CT images and intraoperative images.

Keyword

Blowout fracture; Computed tomography; Fracture image; Trap door fracture

MeSH Terms

Endoscopes
Eye
Humans
Orbit
Orbital Fractures

Figure

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  Figure 1. The size of the orbital wall fracture (arrow) classified into small (A, D), medium (B, E) and large (C, F, H) at inferior (A, B, C), medial (D, E, F) and inferomedial (G, H) orbital wall fracture.

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  Figure 2. The surface of the orbital wall fracture (arrow) classified into mono-fragment fracture (A, C, E), multi-fragment fracture (B, D, F) at inferior (A, B), medial (C, D) and inferomedial (E, F) orbital wall fracture.

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  Figure 3. Different fracture pattern in preoperative CT image and intraoperative real image. (A) Preop CT image: small, mono-fragment, inferior, trapdoor fracture. (B) Intraop real image: medium, multi-fragment, inferior fracture. (C) Preop CT image: small, inferior, trapdoor fracture. (D) Intraop real image: large, inferior fracture. (E) Preop CT image: large, mono-fragment, inferior fracture. (F) Intraop real image: large, multi-fragment inferior fracture.

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  Figure 4. The different size of orbital wall fracture in preop CT image and intraop real image.

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  Figure 5. The different surface of orbital wall fracture in preop CT image and intraop real image.

Reference

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