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Underestimation of soft tissue entrapment by computed tomography in orbital floor fractures in the pediatric population.

Abstract：

PURPOSE:To compare the timing, radiologic, and clinical indications for surgical management of orbital floor fractures in the pediatric and adult populations. DESIGN:Retrospective observational case series. PARTICIPANTS:Twenty-four pediatric and 31 adult patients who underwent primary repair of an orbital floor fracture. METHODS:The records of all patients presenting to the oculoplastics service for primary repair of orbital floor fracture over an 8-year period were reviewed. MAIN OUTCOME MEASURES:Time to surgical intervention, clinical indication for surgery, radiologic evidence, and intraoperative findings of entrapment. RESULTS:Pediatric orbital floor fractures were repaired an average of 3 weeks earlier than adult fractures. The most common clinical indication for surgery was entrapment in the pediatric group versus enophthalmia in the adult group. There was a significant underestimation of entrapment reported on computed tomography (CT) in the pediatric group when compared with the clinical indications and intraoperative findings. Conversely, there was good concordance between radiologic and intraoperative findings in the adult group. CONCLUSIONS:Pediatric orbital floor fractures are often of the trapdoor type, which require earlier surgical intervention. Entrapment and incarceration of orbital soft tissue contents as imaged by CT can be missed by radiologists. Our study demonstrates the poor concordance between radiologic and intraoperative evidence for entrapment in the pediatric population. It is important for the clinician to review all radiologic studies and to perform a thorough ophthalmologic evaluation to aid with clinical decision making.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Parbhu KC,Galler KE,Li C,Mawn LA

doi

10.1016/j.ophtha.2008.02.025

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

1620-5

issue

9

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(08)00202-9

journal_volume

115

pub_type

杂志文章

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