관골 단독 골절에서 안구 용적 변화의 정량적 분석

Quantitative Analysis of the Orbital Volume Change in Isolated Zygoma Fracture

  • 정한주 (인제대학교 의과대학 부산백병원 성형외과학교실) ;
  • 강석주 (인제대학교 의과대학 부산백병원 성형외과학교실) ;
  • 김진우 (인제대학교 의과대학 부산백병원 성형외과학교실) ;
  • 김영환 (인제대학교 의과대학 부산백병원 성형외과학교실) ;
  • 선욱 (인제대학교 의과대학 부산백병원 성형외과학교실)
  • Jung, Han-Ju (Department of Plastic and Reconstructive Surgery, Paik Hospital, Inje University School of Medicine) ;
  • Kang, Seok-Joo (Department of Plastic and Reconstructive Surgery, Paik Hospital, Inje University School of Medicine) ;
  • Kim, Jin-Woo (Department of Plastic and Reconstructive Surgery, Paik Hospital, Inje University School of Medicine) ;
  • Kim, Young-Hwan (Department of Plastic and Reconstructive Surgery, Paik Hospital, Inje University School of Medicine) ;
  • Sun, Hook (Department of Plastic and Reconstructive Surgery, Paik Hospital, Inje University School of Medicine)
  • 투고 : 2011.08.31
  • 심사 : 2011.10.24
  • 발행 : 2011.11.10

초록

Purpose: The zygoma (Zygomaticomaxillary) complexes make up a large portion of the orbital floor and lateral orbital walls. Zygoma fracture frequently causes the posteromedial displacement of bone fragments, and the collapse or overlapping of internal orbital walls. This process consequently can lead to the orbital volume change. The reduction of zygoma in an anterolateral direction may influence on the potential bone defect area of the internal orbital walls. Thus we performed the quantitative analysis of orbital volume change in zygoma fracture before and after operation. Methods: We conducted a retrospective study of preoperative and postoperative three-dimensional computed tomography scans in 39 patients with zygoma fractures who had not carried out orbital wall reconstruction. Orbital volume measurement was obtained through Aquarius Ver. 4.3.6 program and we compared the orbital volume change of injured orbit with that of the normal contralateral orbit. Results: The average orbital volume of normal orbit was 19.68 $cm^3$. Before the operation, the average orbital volume of injured orbit was 18.42 $cm^3$. The difference of the orbital volume between the injured orbit and the normal orbit was 1.18 $cm^3$ (6.01%) on average. After operation, the average orbital volume of injured orbit was 20.81 $cm^3$. The difference of the orbital volume between the injured orbit and the normal orbit was 1.17 $cm^3$ (5.92%) on average. Conclusion: There are considerable volume changes in zygoma fracture which did not accompany internal orbital wall fracture before and after operation. Our study reflects the change of bony frame, also that of all parts of the orbital wall, in addition to the bony defect area of orbital floor, in an isolated zygoma fracture so that it evaluates orbital volume change more accurately. Thus, the measurement of orbital volume in isolated zygoma fractures helps predict the degree of enophthalmos and decide a surgical plan.

키워드

참고문헌

  1. Czerwinski M, Izadpanah A, Ma S, Chankowsky J, Williams HB.: Quantitative analysis of the orbital floor defect after zygoma fracture repair. J Oral Maxillofac Surg 66: 1869, 2008 https://doi.org/10.1016/j.joms.2007.11.014
  2. Kim JC, Ahn HC, Kim IG, Lew JM: Lateral Orbital Wall Fracture: New Classification and Clinical Importance. J Korean Soc Plast Reconstr Surg 28: 121, 2001
  3. Hwang WB, Bae YC, Jeon JY, Hwang SM, Lee J, Kim DH: Orbital volume change in post-traumatic enophthalmos. J Korean Soc Plast Reconstr Surg 24: 1031, 1997
  4. Kelley P, Hopper R, Gruss J: Evaluation and treatment of zygomatic fractures. Plast Reconstr Surg 120: 5S, 2007
  5. Eski M, Sahin I, Deveci M, Turegun M, Isik S, Sengezer M: A retrospective analysis of 101 zygomatico-orbital fractures. J Craniofac Surg 17: 1059, 2006 https://doi.org/10.1097/01.scs.0000235111.92988.b2
  6. Ellis E 3rd, Reddy: Status of the internal orbit after reduction of zygomaticomaxillary complex fractures. J Oral Maxillofac Surg 62: 275, 2004 https://doi.org/10.1016/j.joms.2003.01.006
  7. Tahernia A, Erdmann D, Follmar K, Mukundan S, Grimes J, Marcus JR: Clinical implications of orbital volume change in the management of isolated and zygomaticomaxillary complex-associated orbital floor injuries. Plast Reconstr Surg 123: 968, 2009 https://doi.org/10.1097/PRS.0b013e318199f486
  8. Manson PN, Grivas A, Rosenbaum A, Vannier M, Zinreich J, Iliff N: Studies on enophthalmos: II. The measurement of orbital injuries and their treatment by quantitative computed tomography. Plast Reconstr Surg 77: 203, 1986 https://doi.org/10.1097/00006534-198602000-00005
  9. Ploder O, Klug C, Voracek M, Burggasser G, Czerny C: Evaluation of computer-based area and volume measurement from coronal computed tomography scans in isolated blowout fractures of the orbital floor. J Oral Maxillofac Surg 60: 1267, 2002 https://doi.org/10.1053/joms.2002.35722
  10. Ahn HB, Ryu WY, Yoo KW, Park WC, Rho SH, Lee JH, Choi SS: Prediction of enophthalmos by computer-based volume measurement of orbital fractures in a Korean population. Ophthal Plast Reconstr Surg 24: 36, 2007
  11. Park YJ, Chung IY, Seo SW: An analysis of orbital reconstruction with bioresorbable plate through orbital volume assessment. J Korean Ophthalmol Soc 49: 1046, 2008 https://doi.org/10.3341/jkos.2007.49.7.1046
  12. Ploder O, Oeckher M, Klug C, Voracek M, Wagner A, Burggasser G, Baumann A, Czerny C: Follow-up study of treatment of orbital floor fractures: relation of clinical data and software-based CT-analysis. Int J Oral Maxillofac Surg 32: 257, 2003 https://doi.org/10.1054/ijom.2003.0366
  13. Jeon J, Chon KM, Jung TY, Noh WJ, Kwon JH, Kim YH: Relationship between degree of enophthalmos and orbital volume measured with computed tomography in isolated blowout fractures of the orbit. Korean J Otorhinolaryngol-Head Neck Surg 52: 810, 2009 https://doi.org/10.3342/kjorl-hns.2009.52.10.810
  14. Schuknecht B, Carls F, Valavanis A, Sailer HF: CT assessment of orbital volume in late post-traumatic enophthalmos. Neuroradiology 38: 470, 1996 https://doi.org/10.1007/BF00607281