Blowout Fracture Assessment Based on Computed Tomography and Endoscopy

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Suji Hong ◽  
Joohyun Kim ◽  
Sehyun Baek
Keyword(s):  
Computed Tomography ◽  
Blowout Fracture ◽  
Fracture Assessment

scholarly journals The Utility of Postoperative Computed Tomography Imaging Following Isolated Orbital Blowout Fracture Repair

2020 ◽  
Vol 13 (3) ◽  
pp. 198-204
Author(s):  
Sara E. Francomacaro ◽  
Jana A. Bregman ◽  
Kalpesh T. Vakharia ◽  
Francis L. Grumbine
Keyword(s):  
Computed Tomography ◽  
Medical Records ◽  
Fracture Repair ◽  
Imaging Findings ◽  
Inclusion Criteria ◽  
Computed Tomography Imaging ◽  
Postoperative Imaging ◽  
Reduce Radiation Exposure ◽  
Blowout Fracture ◽  
Care Costs

Purpose: To determine the clinical utility of computed tomography (CT) imaging following isolated orbital blowout fracture (OBF) repair. Methods: Single-center retrospective review of adult patients undergoing surgical repair of isolated OBFs between November 2008 and August 2016 who received postoperative CT scans. Preoperative and postoperative examination data, postoperative imaging reads, postoperative courses, and any reoperation documentation were collected from electronic medical records. Postoperative imaging findings were categorized as major, indeterminate, or minor by predicted impact on clinical management. Major findings indicated a need for reoperation, indeterminate a potential reoperation, and minor no reoperation. Results: Fifty-two cases met inclusion criteria: 94.2% (n = 49) of postoperative scans included minor findings, 34.6% (n = 18) indeterminate findings, and 19.2% (n = 10) major findings. Three patients returned to the operating room (OR) for surgical revision. All 3 had a significant and concerning change on postoperative examination. Only 1 also had a major finding on postoperative imaging. The remaining 49 patients had benign postoperative examinations, despite 9 (17.3%) with major imaging findings who did not undergo reoperation. Conclusions: In the majority of OBF repairs, postoperative CT scan findings were not predictive of a need to return to the OR for revision. Reoperation was instead largely prompted by concerning changes in the postoperative clinical examination. Our findings suggest that postoperative imaging in the absence of clinical concern should not be included in the surgical management of isolated OBFs. Instead, targeted imaging will help reduce radiation exposure and health-care costs without sacrificing patient care.

Comparison of polytomography and computed tomography for fracture assessment

1999 ◽  
Vol 28 (6) ◽  
pp. 330-335 ◽  
Author(s):  
S. J. Kuong ◽  
D. S. Williamson ◽  
N. D. Baker ◽  
J. L. Sosman ◽  
R. D. Nawfel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Fracture Assessment

scholarly journals Intraoperative Computed Tomography Image Fusion for Orbital Blowout Fracture Reconstruction

2021 ◽  
Vol 16 (1) ◽  
pp. 1-12
Author(s):  
Abd Jabar Nazimi ◽  
Syed Nabil
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Image Fusion ◽  
Ct Images ◽  
Head Orientation ◽  
Implant Position ◽  
Orbital Implant ◽  
Intraoperative Computed Tomography ◽  
Implant Malposition ◽  
Blowout Fracture

Intraoperative computed tomography (CT) has been previously described and acknowledged for its use in orbital blowout fracture reconstructions. We described a clinical case series managed by this technique combined with intraoperative image fusion for accuracy in orbital implant position. In total, eight patients who sustained a total number of 19 orbital wall fractures were described. From the total number of 19 blowout orbital fracture reconstructions comprised of medial and inferior (floor) orbital fractures, malposition was identified in a total of four orbital implants by using image fusion. All cases of implant malposition were immediately revised intraoperatively. Subsequent fusion was carried out to confirm whether the revision was satisfactorily achieved. We found that the intraoperative image fusion technique utilised to determine orbital implant position, especially at the posterior ledge, further augmented the role of intraoperative CT scanning. Image fusion conceptually provides an immediate, real-time, and objective solution for intraoperative image analysis and potentially eliminates problems with misaligned CT images. It also reduces the need for the surgeon to ‘eye-ball’ the CT images acquired or the need for additional intraoperative time, since the patient’s head orientation is always axially at random during the acquisition of the CT. Conventional methods for CT image assessment are subjected to one’s own interpretation and may introduce inconsistent or longer intraoperative decision-making. The technique facilitates intraoperative decision-making and reduces the risk of orbital implant malposition in orbital blowout fracture reconstructions. Hence, surgical complication in relation to orbital implant malposition in orbital blowout fracture management could be minimised. In addition, no further postoperative imaging is required.

Break the Fall: Orbital Blowout Fracture

2021 ◽  
pp. 25-38
Author(s):  
Christopher Bugajski
Keyword(s):  
Computed Tomography ◽  
Surgical Intervention ◽  
Orbital Fracture ◽  
Blowout Fracture ◽  
Eyelid Edema ◽  
Fracture Types ◽  
Time Of Presentation ◽  
Head Computed Tomography ◽  
Tomography Scan

Background: Head trauma can lead to multiple ocular complications, among the most concerning is an orbital blowout fracture. Common associations with an orbital fracture would include periorbital ecchymosis, subconjunctival hemorrhage, eyelid edema, and crepitus, among others. Concerning complications, such as retinal detachment, need to be ruled out at the time of presentation. Surgical intervention may be warranted in certain cases. An emergent head computed tomography scan must be performed to evaluate and determine management. Case Report: This case features a 66-year-old Caucasian male with an orbital blowout fracture following a fall. In addition to discussing the details regarding this patient’s case, this report highlights fracture types, pertinent imaging, determination of muscle entrapment, and other underlying complications. Conclusion: Careful evaluation is critical in proper management of potential orbital fracture cases. Entrance testing such as visual acuity measurement, pupil assessment, and extraocular muscle motility evaluation provide useful information regarding suspected severity of an orbital fracture. A dilated fundus examination is necessary for assessing concerning posterior complications. Computed tomography imaging must be obtained in all instances of questionable orbital fracture. Surgical intervention may be needed in some instances. Regardless of the necessity for surgical intervention, careful monitoring of these cases for resolution is advisable.

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