TY - JOUR
T1 - Clinical outcome following intraoperative computed tomography-assisted secondary orbital reconstruction
AU - Shyu, Victor B.
AU - Chen, Hsin Hung
AU - Chen, Chih Hao
AU - Chen, Chien Tzung
N1 - Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2021/2
Y1 - 2021/2
N2 - Background: Secondary post-traumatic orbital reconstructions are challenging. Portable computed tomography (CT) provides the option to acquire real-time, intraoperative images that help to detect the insufficient reconstruction of the orbit immediately. We retrospectively analyzed patients who received intraoperative CT imaging and analyzed the effect of intraoperative CT scans on revision rates and orbital volume changes before, during, and after surgery. Methods: From August 2014 to September 2016, eleven patients received intraoperative cone-beam CT scans to evaluate the results of secondary orbit reconstruction using Medpor + titanium implants. Patient demographics, surgical details, CT scanning protocol, and follow-up results were analyzed. 3D CT volumetry was used to analyze the orbital volume based on OsiriX MD software. Results: Based on intraoperative CT findings, seven cases required intraoperative revision to further augment the orbital cavity or adjust implants. The mean preoperative measured enophthalmos was 3.41±1.4 mm (range: 2–6 mm), which decreased to 0.73±0.4 mm (range: 0–1 mm) at postop assessment (p<0.0001). On the fracture side, there was a significant difference between preoperative vs. intraoperative and preoperative vs. postoperative volume measurements (p<0.01 for both subsets), but no significant difference between intraoperative vs. postoperative measurements. Conclusion: Intraoperative CT is a valuable tool in secondary orbital reconstruction cases based on clinical enophthalmos evaluation and 3D CT volumetry. For these patients, the avoidance of another revision surgery may outweigh the disadvantage of increased operation time and additional radiation exposure.
AB - Background: Secondary post-traumatic orbital reconstructions are challenging. Portable computed tomography (CT) provides the option to acquire real-time, intraoperative images that help to detect the insufficient reconstruction of the orbit immediately. We retrospectively analyzed patients who received intraoperative CT imaging and analyzed the effect of intraoperative CT scans on revision rates and orbital volume changes before, during, and after surgery. Methods: From August 2014 to September 2016, eleven patients received intraoperative cone-beam CT scans to evaluate the results of secondary orbit reconstruction using Medpor + titanium implants. Patient demographics, surgical details, CT scanning protocol, and follow-up results were analyzed. 3D CT volumetry was used to analyze the orbital volume based on OsiriX MD software. Results: Based on intraoperative CT findings, seven cases required intraoperative revision to further augment the orbital cavity or adjust implants. The mean preoperative measured enophthalmos was 3.41±1.4 mm (range: 2–6 mm), which decreased to 0.73±0.4 mm (range: 0–1 mm) at postop assessment (p<0.0001). On the fracture side, there was a significant difference between preoperative vs. intraoperative and preoperative vs. postoperative volume measurements (p<0.01 for both subsets), but no significant difference between intraoperative vs. postoperative measurements. Conclusion: Intraoperative CT is a valuable tool in secondary orbital reconstruction cases based on clinical enophthalmos evaluation and 3D CT volumetry. For these patients, the avoidance of another revision surgery may outweigh the disadvantage of increased operation time and additional radiation exposure.
KW - Enophthalmos
KW - Intraoperative CT
KW - Orbital reconstruction
KW - Volumetry
UR - http://www.scopus.com/inward/record.url?scp=85090959440&partnerID=8YFLogxK
U2 - 10.1016/j.bjps.2020.08.049
DO - 10.1016/j.bjps.2020.08.049
M3 - 文章
C2 - 32948495
AN - SCOPUS:85090959440
SN - 1748-6815
VL - 74
SP - 341
EP - 349
JO - Journal of Plastic, Reconstructive and Aesthetic Surgery
JF - Journal of Plastic, Reconstructive and Aesthetic Surgery
IS - 2
ER -