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Anatomic Factors Predicting Postoperative Strabismus in Orbital Wall Fracture Repair

This study is aimed to determine the relationship between orbital fracture sites in each CT scan view and postoperative diplopia. Data for 141 patients of orbital wall fracture were analyzed retrospectively. One group of examiners reviewed sagittal, coronal and axial CT scans. Descriptive statistica...

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Autores principales: Hsu, Chih-Kang, Hsieh, Meng-Wei, Chang, Hsu-Chieh, Tai, Ming-Cheng, Chien, Ke-Hung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794272/
https://www.ncbi.nlm.nih.gov/pubmed/31616002
http://dx.doi.org/10.1038/s41598-019-51127-7
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author Hsu, Chih-Kang
Hsieh, Meng-Wei
Chang, Hsu-Chieh
Tai, Ming-Cheng
Chien, Ke-Hung
author_facet Hsu, Chih-Kang
Hsieh, Meng-Wei
Chang, Hsu-Chieh
Tai, Ming-Cheng
Chien, Ke-Hung
author_sort Hsu, Chih-Kang
collection PubMed
description This study is aimed to determine the relationship between orbital fracture sites in each CT scan view and postoperative diplopia. Data for 141 patients of orbital wall fracture were analyzed retrospectively. One group of examiners reviewed sagittal, coronal and axial CT scans. Descriptive statistical analysis was used to assess each fracture area and its potential relationship with the occurrence of postoperative diplopia. Among the three anatomical views, sagittal sections were significantly associated with post-operative diplopia (PD) (p = 0.044). For orbital wall fractures in a single location, C1 (p = 0.015), A1 (p = 0.004) and S3 (p = 0.006) fractures were significantly related to PD. Orbital wall fractures found in more than one location resulted in a higher probability of PD in all sections:, C1 + C2 group (p = 0.010), C1 + C2 + C3 group (p = 0.005), A1 + A2 group (p = 0.034), A3 + A1 group (p = 0.005), S1 + S2 group (p < 0.001), S2 + S3 group (p = 0.006) and S1 + S2 + S3 group (p < 0.001). For combinations of two or three sections, we found that only fractures involving both coronal and sagittal sections led to a significantly increased risk of PD (p = 0.031). PD is the main posttreatment complication of orbital bone fracture reduction. In addition to the known myogenic cause (failure to relieve entrapment) of diplopia, both trauma and surgical manipulation can compromise ocular motor nerve function and possibly result in the development of neurogenic causes of diplopia. Careful assessment of patient symptoms (whether preoperative diplopia is present), and the location of orbital fractures (and the influence of related musculature, fat, and nerves) on CT scans are strongly related to surgical success.
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spelling pubmed-67942722019-10-25 Anatomic Factors Predicting Postoperative Strabismus in Orbital Wall Fracture Repair Hsu, Chih-Kang Hsieh, Meng-Wei Chang, Hsu-Chieh Tai, Ming-Cheng Chien, Ke-Hung Sci Rep Article This study is aimed to determine the relationship between orbital fracture sites in each CT scan view and postoperative diplopia. Data for 141 patients of orbital wall fracture were analyzed retrospectively. One group of examiners reviewed sagittal, coronal and axial CT scans. Descriptive statistical analysis was used to assess each fracture area and its potential relationship with the occurrence of postoperative diplopia. Among the three anatomical views, sagittal sections were significantly associated with post-operative diplopia (PD) (p = 0.044). For orbital wall fractures in a single location, C1 (p = 0.015), A1 (p = 0.004) and S3 (p = 0.006) fractures were significantly related to PD. Orbital wall fractures found in more than one location resulted in a higher probability of PD in all sections:, C1 + C2 group (p = 0.010), C1 + C2 + C3 group (p = 0.005), A1 + A2 group (p = 0.034), A3 + A1 group (p = 0.005), S1 + S2 group (p < 0.001), S2 + S3 group (p = 0.006) and S1 + S2 + S3 group (p < 0.001). For combinations of two or three sections, we found that only fractures involving both coronal and sagittal sections led to a significantly increased risk of PD (p = 0.031). PD is the main posttreatment complication of orbital bone fracture reduction. In addition to the known myogenic cause (failure to relieve entrapment) of diplopia, both trauma and surgical manipulation can compromise ocular motor nerve function and possibly result in the development of neurogenic causes of diplopia. Careful assessment of patient symptoms (whether preoperative diplopia is present), and the location of orbital fractures (and the influence of related musculature, fat, and nerves) on CT scans are strongly related to surgical success. Nature Publishing Group UK 2019-10-15 /pmc/articles/PMC6794272/ /pubmed/31616002 http://dx.doi.org/10.1038/s41598-019-51127-7 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Hsu, Chih-Kang
Hsieh, Meng-Wei
Chang, Hsu-Chieh
Tai, Ming-Cheng
Chien, Ke-Hung
Anatomic Factors Predicting Postoperative Strabismus in Orbital Wall Fracture Repair
title Anatomic Factors Predicting Postoperative Strabismus in Orbital Wall Fracture Repair
title_full Anatomic Factors Predicting Postoperative Strabismus in Orbital Wall Fracture Repair
title_fullStr Anatomic Factors Predicting Postoperative Strabismus in Orbital Wall Fracture Repair
title_full_unstemmed Anatomic Factors Predicting Postoperative Strabismus in Orbital Wall Fracture Repair
title_short Anatomic Factors Predicting Postoperative Strabismus in Orbital Wall Fracture Repair
title_sort anatomic factors predicting postoperative strabismus in orbital wall fracture repair
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794272/
https://www.ncbi.nlm.nih.gov/pubmed/31616002
http://dx.doi.org/10.1038/s41598-019-51127-7
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