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Quantitative assessment of bony orbital volume symmetry: CT analysis in the uninjured Caucasian population

Published:February 16, 2022DOI:https://doi.org/10.1016/j.bjoms.2022.02.002

      Abstract

      There is a surprising lack of evidence documenting the volumetric symmetry of the bony orbit. This paper establishes reference values for orbital volume (OV) and symmetry in the 25 - 40 year old Caucasian population. Secondarily, this paper sets a landmark for the tolerances in OV that can be expected when reconstructing the bony defects which may occur from trauma.
      A standardised method of quantitative OV measurement was developed using CT sinus examinations acquired for indications unrelated to orbital trauma. Sex, ethnicity, age, right and left OV were recorded. Data for 100 patients was obtained (50 male, 50 female).
      Mean left OV was 23.1cm3 and mean right OV was 23.3cm3. Left and right OV were strongly positively correlated (correlation coefficient: 0.96). Mean female OV was 21.6cm3 and mean male OV was 24.8cm3. On average, male OV is 3.2cm3 larger than female OV. The mean difference between left and right OV was 0.5cm3 in females and 0.6cm3 in males. The intra-class coefficient score between the two assessors was 0.973 (excellent).
      There is strong positive correlation between left and right OV in this study population. Previous work suggests that orbital volume loss less than 1cm3 would not lead to significant clinical symptoms of orbital fracture. When orbital reconstruction is undertaken, this study suggests that a volume symmetry difference of <0.5cm3 in females and <0.6cm3 in males would be consistent with the variation seen in the study population of uninjured Caucasian 25-40 year olds and is therefore a reasonable goal of surgical management.

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      References

        • Boffano P.
        • Roccia F.
        • Zavattero E.
        • et al.
        European Maxillofacial Trauma (EURMAT) project: a multicentre and prospective study.
        J Craniomaxillofac Surg. 2015; 43: 62-70https://doi.org/10.1016/j.jcms.2014.10.011
        • Tong L.
        • Bauer R.J.
        • Buchman S.R.
        A current 10-year retrospective survey of 199 surgically treated orbital floor fractures in a nonurban tertiary care center.
        Plast Reconstr Surg. 2001; 108: 612-621https://doi.org/10.1097/00006534-200109010-00003
        • Manson P.N.
        • Grivas A.
        • Rosenbaum A.
        • et al.
        Studies on enophthalmos: II. The measurement of orbital injuries and their treatment by quantitative computed tomography.
        Plast Reconstr Surg. 1986; 77: 203-214
        • Sugiura K.
        • Yamada H.
        • Okumoto T.
        • et al.
        Quantitative assessment of orbital fractures in Asian patients: CT measurement of orbital volume.
        J Craniomaxillofac Surg. 2017; 45: 1944-1947https://doi.org/10.1016/j.jcms.2017.09
        • Ahmad Nasir S.
        • Ramli R.
        • Abd Jabar N.
        Predictors of enophthalmos among adult patients with pure orbital blowout fractures.
        PLoS One. 2018; 13https://doi.org/10.1371/journal.pone.0204946
        • Kunz C.
        • Sigron G.
        • Jaquiéry C.
        Functional outcome after non-surgical management of orbital fractures-the bias of decision-making according to size of defect: Critical review of 48 patients.
        Br J Oral Maxillofac Surg. 2013; 51: 486-492https://doi.org/10.1016/j.bjoms.2012.09.016
        • Tahernia A.
        • Erdmann D.
        • Follmar K.
        Clinical implications of orbital volume change in the management of isolated and zygomaticomaxillary complex-associated orbital floor injuries.
        Plast Reconstr Surg. 2009; 123: 968-975https://doi.org/10.1097/PRS.0B013E318199F486
        • Zimmerer R.M.
        • Ellis 3rd, E.
        • Aniceto G.S.
        • et al.
        A prospective multicenter study to compare the precision of posttraumatic internal orbital reconstruction with standard preformed and individualized orbital implants.
        J Craniomaxillofac Surg. 2016; 44: 1485-1497https://doi.org/10.1016/j.jcms.2016.07.014
        • Furuta M.
        Measurement of orbital volume by computed tomography: especially on the growth of the orbit.
        Jpn J Ophthalmol. 2001; 45: 600-606https://doi.org/10.1016/s0021-5155(01)00419-1
        • Andrades P.
        • Cuevas P.
        • Hernández R.
        • et al.
        Characterization of the orbital volume in normal population.
        J Craniomaxillofac Surg. 2018; 46: 594-599https://doi.org/10.1016/j.jcms.2018.02.003
        • Tandon R.
        • Aljadeff L.
        • Ji S.
        • et al.
        Anatomic variability of the human orbit.
        J Oral Maxillofac Surg. 2020; 78: 782-796https://doi.org/10.1016/j.joms.2019.11.032
        • Seiji F.
        • Moreira R.S.
        • Antonio De Angelis M.
        • et al.
        Orbital asymmetry in development: an anatomical study.
        Orbit. 2009; 28: 342-346https://doi.org/10.3109/01676830903162841
        • Koo L.
        • Hatton M.P.
        • Rubin P.A.
        When is Enophthalmos “Significant”?.
        Ophthalmic Plast Reconstr Surg. 2006; 22: 274-277https://doi.org/10.1097/01.iop.0000226865.22184.6a
        • Fan X.
        • Li J.
        • Zhu J.
        • et al.
        Computer-assisted orbital volume measurement in the surgical correction of late enophthalmos caused by blowout fractures.
        Ophthalmic Plast Reconstr Surg. 2003; 19: 207-211https://doi.org/10.1097/01.iop.0000062848.26273.e5
        • Ploder O.
        • Klug C.
        • Voracek M.
        • et al.
        Evaluation of computer-based area and volume measurement from coronal computed tomography scans in isolated blowout fractures of the orbital floor.
        J Oral Maxillofac Surg. 2002; 60 (discussion 1273-1264): 1267-1272https://doi.org/10.1053/joms.2002.35722
        • Raskin E.M.
        • Millman A.L.
        • Lubkin V.
        • et al.
        Prediction of late enophthalmos by volumetric analysis of orbital fractures.
        Ophthalmic Plast Reconstr Surg. 1998; 14: 19-26https://doi.org/10.1097/00002341-199801000-00006
        • Schouman T.
        • Courvoisier D.S.
        • Van Issum C.
        • et al.
        Can systematic computed tomographic scan assessment predict treatment decision in pure orbital floor blowout fractures?.
        J Oral Maxillofac Surg. 2012; 70: 1627-1632https://doi.org/10.1016/j.joms.2012.03.006