Correlation between Tomography Scan Findings and Clinical Presentation and Treatment Outcomes in Patients with Orbital Floor Fractures

TL;DR

This study explores how CT scan findings relate to symptoms and treatment outcomes in patients with orbital floor fractures.

Contribution

The study provides new evidence challenging the assumption that muscle entrapment causes impaired eye movement in these fractures.

Findings

A larger hernia into the maxillary sinus correlates with worse outcomes in infraorbital paresis and asymmetric eyeball placement.

No significant correlation was found between rectus inferior muscle entrapment and impaired ocular mobility.

CT-based findings show significant correlations with clinical symptoms and treatment outcomes in orbital floor fractures.

Abstract

Background: Orbital floor fractures involve damage to the orbital floor but not the infraorbital margin. Despite intensive research, they remain a controversial topic. The aim of this study was to investigate the relationship between parameters gathered by means of computed tomography (CT), the clinical presentation, and treatment outcomes, in patients suffering from orbital floor fractures. Methods: Forty patients with orbital floor fractures were included in this study. Information regarding diplopia, impaired ocular mobility, asymmetric eyeball placement, and infraorbital paresis was gathered from the medical records. Nine CT-based parameters were assessed. Two parameters were calculated, based on them. The follow-up data of 30 patients were analyzed. The results were statistically evaluated. The significance level was p < 0.05. Results: Statistical evaluation revealed multiple correlations between CT-based findings, symptoms, and treatment results. Among others, the hernia into the maxillary sinus was significantly larger in patients without improvement in infraorbital paresis (p = 0.0031) and without improvement in assymetric eyeball placement (p = 0.0037). There was no correlation between the entrapment of the rectus inferior muscle and impaired ocular mobility (p = 0.664431; p = 0.420289) and between the direct fracture of the infraorbital canal and infraorbital paresis (p = 0.371102). Conclusions: The widely assumed thesis that impaired ocular mobility in orbital fractures is caused by entrapment of the rectus inferior muscle is disproved by CT-based data. CT-based findings, symptoms, and treatment results in patients with orbital floor fractures were significantly correlated. A large hernia may be a negative prognostic factor.

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