Prediction of Complications Using Three-Dimensional Analysis in Blowout Fractures
Author: Dong Gyu Kim Base Hospital / Institution: Department of Plastic and Reconstructive Surgery, Soonchunhyang University, Bucheon Hospital, College of Medicine, Soonchunhyang University, Bucheon, Republic of KoreaePoster presentation
Abstract ID: 26-330Purpose
Conventional surgical indications for orbital blowout fractures, including early enophthalmos and fracture size, do not adequately reflect three-dimensional orbital volume change. This study aimed to validate a simplified volumetric formula derived from a three-dimensional integral model for predicting permanent enophthalmos and to assess its clinical utility in early surgical decision making.
Methods
A three-dimensional integral model of the orbit was developed to estimate globe displacement from bilateral orbital volume differences on computed tomography. Validation was performed in 52 untreated blowout fracture patients from four centers with at least 2 years of follow-up. The formula was further applied to preoperative CT scans of 768 patients with pure blowout fractures to evaluate predicted enophthalmos and its association with fracture area and extra-ocular muscle herniation.
Results
In the untreated patients, mean predicted enophthalmos was 2.04 millimeter, closely matching measured permanent enophthalmos of 2.02 millimeter. Predicted and measured values showed a strong positive correlation (R-squared=0.745, regression coefficient=0.89), with a mean difference of 0.02 millimeter. In the 768 patient cohort, mean predicted enophthalmos was 1.84 millimeter. Fracture area and extra-ocular muscle herniation showed no meaningful correlation with predicted enophthalmos.
Conclusion
Automated bilateral orbital volumetry combined with a three-dimensional integral formula provides a practical and reproducible method for early prediction of permanent enophthalmos after blowout fracture. This approach may improve selection of patients who require surgery more accurately than conventional two-dimensional radiologic parameters.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Ho Seong | Shin | Department of Plastic and Reconstructive Surgery, Soonchunhyang University, Bucheon Hospital, College of Medicine, Soonchunhyang University, Bucheon, Republic of Korea |
| Juna | Shin | Department of Statistics, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA |
