Volumetric evaluation of orbital fractures treated by titanium mesh

Abstract

Abstract Purpose: Orbital fractures are high prevalent and result in volumetric changes which may result in clinical impairment as enophthalmos and diplopia. This study aims to evaluate orbital volume and anteroposterior eyeball position in orbital fractures treated by titanium mesh. Methods: This multicenter study evaluated 60 postoperative CT scans of unilateral orbital fractures treated using titanium mesh. Orbital defects were classified according to the extension and involved regions, and the orbital volumes were analyzed by two methods, image sectioning (IS) and computerized segmentation (CS). The eyeball position was obtained from the axial slice in the mid orbit region. Differences up to 8.0% (volume) and 2.0 mm (eyeball position) were considered normal. Results: Most of defects were class II (n=25) and class III (n=26). Volumetric differences between unaffected and reconstructed orbit ranged from -7.15% to 10.46% (mean: -0.15%), and from -6.32% to 9.69% (mean: -0.01%) in IS and CS method, respectively. In both methods, two reconstructions were greater than anatomical differences, however there was no statistical differences between the orbits in both methods, IS (p=0.852) and CS (p=0.987). Anteroposterior eyeball position ranged from -0.9 mm to 1.8 mm. The correlation between defect classification, eyeball position and IS or CS, were not positive. Conclusion: In conclusion, regardless of the extent of the orbital defect or evaluation method, fractures treated by titanium mesh reestablished adequately the orbital volume.