Perioperative Orbital Volume Change in Blowout Fracture Correction through Endoscopic Transnasal Approach

Lee, Jae Woo; Nam, Su Bong; Choi, Soo Jong; Kang, Cheol Uk; Bae, Yong Chan

Abstract

PURPOSE
Endoscopic transnasal correction of the blowout fractures has many advantages over other techniques. But after removal of packing material, there were some patients with recurrence of preoperative symptoms. Authors tried to make a quantitative anterograde analysis of orbital volume change over whole perioperative period which might be related with recurrence of preoperative symptoms.
METHODS
10 patients with pure medial wall fracture(Group I) and 10 patients with medial wall fracture combined with fracture of orbital floor(Group II) were selected to evaluate the final orbital volume change with 3 CT scans, preoperatively, postoperatively and 4 months after packing removal. By multiplying cross-section area of orbit in coronal view with section thickness, orbital volume were calculated. Then, mean orbital volume increment after trauma, mean orbital volume decrement after endoscopic correction and volume increment after packing removal were found out. And we tried to find correlations between type of fracture, initial correction rate and final correction rate.
RESULTS
The mean orbital volume increase of the fractured orbits were 7.23% in group I and 13.69% in group II. After endoscopic surgery, mean orbital volume decrease were 11.0% in group I and 12.46% in group II. Mean volume increase after packing removal showed 3.10% in group I and 6.50% in group II. The initial correction rate(%) showed linear correlation with final correction rate(%) after packing removal. And there were negative linear correlation between increment percentage of orbital volume by fracture and final correction rate(%).
CONCLUSION
Orbital volume was proved to be increasing after removal of packing or foley catheter and it was dependent upon type of fracture. Overcorrection should be done to improve the final result of orbital blowout fracture especially when severe fracture is present.