Rounding of the inferior rectus muscle as an indication of orbital floor fracture with periorbital disruption.

A. Banerjee, C. Moore, R. Tse, Damir B. Matic
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引用次数: 28

Abstract

OBJECTIVE To determine if rounding of the inferior rectus muscle on coronal computed tomographic (CT) scans predicts disruption of the periorbita in orbital floor fractures and therefore predicts delayed enophthalmos. DESIGN Cadaveric study with CT scan analysis. SETTING Cadaveric laboratory and CT scanner at a tertiary care hospital in London, Ontario. METHODS Each orbit of each cadaveric head was randomly assigned to have either intact or disrupted periorbita. Progressively larger orbital floor fractures were made and CT scans were taken before fractures and after each fracture to assess the shape of the inferior rectus muscle. Measurements were made of the length of the long and short axis of the inferior rectus muscle using CT analysis software. The short to long axis ratio was then compared. MAIN OUTCOME MEASURES Change in the short to long axis ratio of the inferior rectus muscle and correlation of the ratio with intact and disrupted periorbita. RESULTS Orbital floor fractures measuring 1 x 1 cm show an increase in the short to long axis ratio (rounding) of the inferior rectus muscle only if the periorbita is disrupted. Orbital floor fractures measuring 2 x 2 cm show rounding of the inferior rectus muscle regardless of whether the periorbita is intact or disrupted; however, the degree of rounding is greater if the periorbita is disrupted. CONCLUSIONS For small orbital floor fractures, rounding of the inferior rectus muscle predicts periorbital disruption. This may therefore represent an indication for early surgical repair to prevent delayed enophthalmos.
下直肌变圆表明眶底骨折伴眶周破裂。
目的探讨冠状位计算机断层扫描(CT)显示下直肌圆形是否预示眶底骨折时眶周破裂,从而预测延迟性眼内陷。设计:尸体CT扫描分析研究。背景:安大略省伦敦一家三级保健医院的尸体实验室和CT扫描仪。方法将每个尸体头部的眶周随机分为完整眶周和破坏眶周两组。眶底骨折逐渐变大,骨折前和每次骨折后进行CT扫描,以评估下直肌的形状。采用CT分析软件测量下直肌长、短轴长度。然后比较短轴与长轴的比值。主要观察指标:下直肌短轴与长轴比值的变化及其与眶周完整和破坏的相关性。结果1 × 1 cm的眶底骨折仅在眶周破坏时才显示下直肌短轴比与长轴比(圆)增加。眶底骨折大小为2 x 2 cm,无论眶周是否完整或断裂,均显示下直肌变圆;然而,如果眶周被破坏,圆角的程度会更大。结论对于小的眶底骨折,下直肌围圆可预测眶周骨折。因此,这可能是早期手术修复以防止迟发性眼内陷的指征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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