ePoster listing and sessions

Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London

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A functional radiological and soft tissue classification to predict outcomes in orbital fracture surgery in a multidisciplinary ‘real-world’ setting.

Author: Shu-Yi Claire Chan
ePoster Number: 247

Purpose

The decision for open reduction and internal fixation (ORIF) of orbital fractures is usually based on clinical severity and soft tissue and bony findings. This study aimed to identify prognostic factors for a successful surgical outcome.

Methods

We included all orbital fractures treated by ORIF on our orbital trauma multidisciplinary pathway over a twelve-year period. A successful outcome was defined as i) a single operation, ii) improved diplopia and globe position at 6 months, iii) no surgical complications and iv) patient satisfaction. Data was collected on presenting symptoms, orthoptic measurements, time interval from injury to surgery, fracture geometry and involvement of internal and external bony landmarks. Univariate and multivariate regression was used to identify predictive factors for success.

Results

143 cases were included with median age 35.4 years and 81.8% male. 51% had complex fractures involving multiple orbital walls. 63.6% achieved significant improvement in both enophthalmos and diplopia at 6 months. 15.3% had significant preoperative soft tissue or neurogenic injury. 11.8% required orbital plate repositioning or removal. 1.4% developed orbital haematoma and 4.2% had cicatricial entropion. Pre-operative nerve or muscle damage (OR 0.05, p=0.01) and infraorbital fissure fracture (OR 0.38, p=0.04) were associated with poor outcomes, whereas an intact posterior ledge was associated with successful outcomes (OR 3.03, p=0.02).

Conclusion

Careful ocular motility evaluation to ascertain neurogenic injury and muscle compartment syndrome, and radiological analysis of the integrity of the posterior ledge and the inferior orbital fissure can facilitate management and expectations of ORIF surgery.

Additional Authors

Abstract ID: 21-142