Measurement Analytical Study of Computed Tomography of the Orbital Structure in Acute Blow-out Fracture.

Jeong, Seong Ho; Shin, Seung Han; Park, Seung Ha; Koo, Sang Hwan

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(1):44-51.
Published online January 1, 2007.

Measurement Analytical Study of Computed Tomography of the Orbital Structure in Acute Blow-out Fracture.

Seong Ho Jeong, Seung Han Shin, Seung Ha Park, Sang Hwan Koo

Department of Plastic & Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea. shkoo@korea.ac.kr

Abstract

PURPOSE
Blow-out fracture is one of the most common fractures in facial trauma. It is diagnosed by Computed Tomography(CT) scan, which is considered as the most effective diagnostic tool. Since, the Picture Archiving Communication System(PACS) has been provided recently to many hospitals, doctors are more familiar with imaging software of PACS. Because this software has many useful measuring tools, doctors can measure orbital structure easily and make a plan for treatment with its data. Therefore, authors intended to analyze the data of orbital structure measured with PACS imaging software and evaluate its usefulness. METHODS: The charts and CT images of 100 patients, which were 50 patients with medial wall fracture and 50 patients with floor fracture, were reviewed. Patients were selected by pre-determined criteria and their CT images were measured with image software of PACS. 'Extraocular muscle thickness', 'Defect ratio'(ratio of defect area to normal area) and 'Globe position index' were measured and analyzed statistically.
RESULTS
The thickness of inferior rectus muscle and medial rectus muscle was simultaneously increased in acute-stage of blow-out fracture. The medial rectus muscle was more thickened in medial wall fracture and inferior rectus was more thickened in floor fracture, respectively. In acute blow-out fracture, globe position is exophthalmic rather than enophthalmic. Especially in floor fracture, numerical value summed up thickness of all extraocular muscle is correlated to the defect ratio and globe position index.
CONCLUSION
Clinicians can decide globe position or presume defect ratio in inferior wall fracture by measurement of CT image in acute blow-out fracture using PACS.

Keywords: Blow out fracture; CT; PACS

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