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Sex-related and racial variations in orbital floor anatomy

  • Moon, Seung Jin (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Won Jai (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine) ;
  • Roh, Tai Suk (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine) ;
  • Baek, Wooyeol (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine)
  • Received : 2020.04.17
  • Accepted : 2020.06.01
  • Published : 2020.08.20

Abstract

Background: Repair of the orbital floor following trauma or tumor removal remains a challenge because of its complex three-dimensional shape. The purpose of the present study is to understand normal orbital floor anatomy by investigating its differences across four groups (Caucasian American and East Asian, males and females) via facial bone computed tomography (CT). Methods: A total of 48 orbits in 24 patients between 20 and 60 years of age were evaluated. Although most patients underwent CT scanning following trauma, the orbital walls were intact in all patients. Linear and angular measurements of the orbital floor were obtained from CT images. Results: Orbital floor width, length, angle between the orbital floor and medial wall, and distance from the inferior orbital rim to the lowest point of the orbital floor did not show a statistically significant difference between groups. Angles made by the infraorbital rim, the lowest point of the floor, and the anterior border of the infraorbital fissure were statistically significantly wider in East Asian females than in male groups. The floor depth in East Asian females was significantly smaller compared to all the other groups. Conclusion: East Asian female population had smaller curvature and depth of an orbital floor than the other groups, which means racial and sex-related differences should be considered in the orbital floor reconstruction.

Keywords

References

  1. Hoffmann J, Cornelius CP, Groten M, Probster L, Pfannenberg C, Schwenzer N. Orbital reconstruction with individually copy-milled ceramic implants. Plast Reconstr Surg 1998;101:604-12. https://doi.org/10.1097/00006534-199803000-00006
  2. Chang EW, Manolidis S. Orbital floor fracture management. Facial Plast Surg 2005;21:207-13. https://doi.org/10.1055/s-2005-922861
  3. Manolidis S, Weeks BH, Kirby M, Scarlett M, Hollier L. Classification and surgical management of orbital fractures: experience with 111 orbital reconstructions. J Craniofac Surg 2002;13:726-37. https://doi.org/10.1097/00001665-200211000-00002
  4. Kozakiewicz M, Elgalal M, Loba P, Komunski P, Arkuszewski P, Broniarczyk-Loba A, et al. Clinical application of 3D pre-bent titanium implants for orbital floor fractures. J Craniomaxillofac Surg 2009;37:229-34. https://doi.org/10.1016/j.jcms.2008.11.009
  5. Vehmeijer M, van Eijnatten M, Liberton N, Wolff J. A novel method of orbital floor reconstruction using virtual planning, 3-dimensional printing, and autologous bone. J Oral Maxillofac Surg 2016;74:1608-12. https://doi.org/10.1016/j.joms.2016.03.044
  6. Hammer B, Prein J. Correction of post-traumatic orbital deformities: operative techniques and review of 26 patients. J Craniomaxillofac Surg 1995;23:81-90. https://doi.org/10.1016/S1010-5182(05)80453-6
  7. Kang HS, Han JJ, Oh HK, Kook MS, Jung S, Park HJ. Anatomical studies of the orbital cavity using three-dimensional computed tomography. J Craniofac Surg 2016;27:1583-8. https://doi.org/10.1097/SCS.0000000000002811
  8. Weaver AA, Loftis KL, Tan JC, Duma SM, Stitzel JD. CT based three-dimensional measurement of orbit and eye anthropometry. Invest Ophthalmol Vis Sci 2010;51:4892-7. https://doi.org/10.1167/iovs.10-5503
  9. Hwang K, You SH, Sohn IA. Analysis of orbital bone fractures: a 12-year study of 391 patients. J Craniofac Surg 2009;20:1218-23. https://doi.org/10.1097/SCS.0b013e3181acde01
  10. Kim YC, Jeong WS, Park TK, Choi JW, Koh KS, Oh TS. The accuracy of patient specific implant prebented with 3D-printed rapid prototype model for orbital wall reconstruction. J Craniomaxillofac Surg 2017;45:928-36. https://doi.org/10.1016/j.jcms.2017.03.010
  11. Schmelzeisen R, Gellrich NC, Schoen R, Gutwald R, Zizelmann C, Schramm A. Navigation-aided reconstruction of medial orbital wall and floor contour in cranio-maxillofacial reconstruction. Injury 2004;35:955-62. https://doi.org/10.1016/j.injury.2004.06.005
  12. Nagasao T, Hikosaka M, Morotomi T, Nagasao M, Ogawa K, Nakajima T. Analysis of the orbital floor morphology. J Craniomaxillofac Surg 2007;35:112-9. https://doi.org/10.1016/j.jcms.2006.12.002
  13. Kumaran A, Chan A, Yong K, Shen S. Ethnic variation in deep lateral orbital anatomy and its implications on decompression surgery. Orbit 2019;38:95-102. https://doi.org/10.1080/01676830.2018.1441316
  14. Patnaik VVG, Bala S, Singla R. Anatomy of the bony orbitsome applied aspects. J Anat Soc India 2001;50:59-67.