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Jaehwan Kwon, MD; Jose E. Barrera, MD; Tae-Young Jung, MD; Sam P. Most, MD

Arch Facial Plast Surg. 2009;11(6):395-398.

Objectives  To measure the orbital volume of unilateral pure blowout fractures with computed tomography before and after surgery and to compare 3-dimensional (3-D) imaging systems.

Methods  Twenty-four patients were evaluated with facial computed tomographic scans before and after surgery. Both the orbital volume and the displaced soft tissue volume were measured by 2 operators using 2 different 3-D software programs (Vitrea; Vital Images Inc, Minnetonka, Minnesota; and Dextroscope; Bracco AMT Inc, Princeton, NJ).

Results  The mean (SD) normal orbital volumes calculated by Vitrea and Dextroscope were 25.5 (2.4) mL and 24.8 (3.0) mL, respectively. The average preoperative orbital volumes were 28.3 (2.3) mL and 27.6 (3.1) mL, while the postoperative volumes were 25.8 (2.5) mL and 24.9 (3.0) mL. Vitrea showed that the average volume of displaced orbital soft tissue was 2.8 (1.9) mL before surgery and that it was reduced to 0.3 (1.3) mL after surgery, while Dextroscope showed that the average displaced orbital soft tissue was 2.9 (1.4) mL before surgery and that it was reduced to 0.1 (1.2) mL after surgery. There was no statistical difference between the 3-D analysis programs.

Conclusions  Consistent volume measurements can be obtained using different 3-D image analysis programs. Measuring preoperative and postoperative volume changes and postoperative reduction can ensure a good surgical result and thereby decrease the incidence of enophthalmos.

Author Affiliations: Division of Facial Plastic Surgery and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Stanford University, Stanford, California (Drs Kwon, Barrera, and Most); and Department of Otolaryngology–Head and Neck Surgery, Maryknoll Medical Center, Busan, Korea (Dr Jung).

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