TY - JOUR
T1 - Conservatively Treated Orbital Blowout Fractures
T2 - Spontaneous Radiologic Improvement
AU - Young, Stephanie Ming
AU - Kim, Yoon Duck
AU - Kim, Sang Wook
AU - Jo, Han Byeol
AU - Lang, Stephanie S.
AU - Cho, Kyuyeon
AU - Woo, Kyung In
N1 - Publisher Copyright:
© 2018 American Academy of Ophthalmology
PY - 2018/6
Y1 - 2018/6
N2 - Purpose: To determine if conservatively treated blowout fractures of the orbit undergo spontaneous improvement based on radiologic findings. Design: Prospective, noncomparative series. Participants: Patients with conservatively treated orbital blowout fractures in a single tertiary institution from 2012 through 2016 with initial and follow-up computed tomography (CT) scans. Methods: Comparison of initial and follow-up CT to assess for smoothening of bony contour, joining of bony edges, reduction in herniation of orbital contents, and new bone formation. Orbital and fracture volumes were calculated using a 3-dimensional reconstruction software program (3D Workstation; TeraRecon, Foster City, CA). Main Outcome Measures: Change in bony contour, new bone formation, and decrease in orbital and fracture volumes. Results: Our study comprised 41 patients and 44 orbits, with 38 unilateral and 3 bilateral cases. Most were men (65.9%; n = 27), and the mean age was 34.3±13.5 years. The mean time from injury to follow-up scan was 4.6 months (range, 1–15 months). All orbits showed changes in bony contour from initial to follow up CT, including smoothening of the orbital contour (88.6%), joining of bony edges (90.9%), and reduction in herniation of orbital contents (65.9%). Most of the orbits (n = 41; 93.2%) showed features of neobone formation. Of the 44 orbits, 91.4% showed a decrease in orbital volume, whereas 94.3% showed a decrease in fracture volume. The reduction in volume was statistically significant for both orbital (from 23.7±4.0 to 21.8±3.9 ml) as well as fracture (from 1.2±0.8 to 0.7±0.6 ml) volumes from initial to follow-up scans, respectively (P < 0.001). Conclusions: A large proportion of patients showed improvement in radiologic findings despite being treated conservatively. This highlights the spontaneous improvement that can occur in untreated blowout fractures not just clinically, but radiologically, in terms of soft tissue and bony findings.
AB - Purpose: To determine if conservatively treated blowout fractures of the orbit undergo spontaneous improvement based on radiologic findings. Design: Prospective, noncomparative series. Participants: Patients with conservatively treated orbital blowout fractures in a single tertiary institution from 2012 through 2016 with initial and follow-up computed tomography (CT) scans. Methods: Comparison of initial and follow-up CT to assess for smoothening of bony contour, joining of bony edges, reduction in herniation of orbital contents, and new bone formation. Orbital and fracture volumes were calculated using a 3-dimensional reconstruction software program (3D Workstation; TeraRecon, Foster City, CA). Main Outcome Measures: Change in bony contour, new bone formation, and decrease in orbital and fracture volumes. Results: Our study comprised 41 patients and 44 orbits, with 38 unilateral and 3 bilateral cases. Most were men (65.9%; n = 27), and the mean age was 34.3±13.5 years. The mean time from injury to follow-up scan was 4.6 months (range, 1–15 months). All orbits showed changes in bony contour from initial to follow up CT, including smoothening of the orbital contour (88.6%), joining of bony edges (90.9%), and reduction in herniation of orbital contents (65.9%). Most of the orbits (n = 41; 93.2%) showed features of neobone formation. Of the 44 orbits, 91.4% showed a decrease in orbital volume, whereas 94.3% showed a decrease in fracture volume. The reduction in volume was statistically significant for both orbital (from 23.7±4.0 to 21.8±3.9 ml) as well as fracture (from 1.2±0.8 to 0.7±0.6 ml) volumes from initial to follow-up scans, respectively (P < 0.001). Conclusions: A large proportion of patients showed improvement in radiologic findings despite being treated conservatively. This highlights the spontaneous improvement that can occur in untreated blowout fractures not just clinically, but radiologically, in terms of soft tissue and bony findings.
UR - https://www.scopus.com/pages/publications/85041579987
U2 - 10.1016/j.ophtha.2017.12.015
DO - 10.1016/j.ophtha.2017.12.015
M3 - Article
C2 - 29398084
AN - SCOPUS:85041579987
SN - 0161-6420
VL - 125
SP - 938
EP - 944
JO - Ophthalmology
JF - Ophthalmology
IS - 6
ER -