Dynamic soft tissue changes in the orbit after a blowout fracture

Abstract

Background/objectives: The intraorbital contents are thought to be affected by oedema in the days following a blowout fracture. We posit that this oedema can be detected by Magnetic resonance imaging (MRI) as changes in muscle volume, in muscle cross-sectional area, and in the MRI parameter ‘mean grey value’ (MGV) of the orbital fat and extraocular muscles (EOMs).

Materials and methods: Patients with a blowout fracture underwent an MRI scan within 72 h after the trauma and again after 10–14 days. Measurements of EOMS and fat tissue on the fractured orbit were compared to the unfractured orbit.

Results: Eighteen patients were included. Measurements showed significantly larger volume, cross-sectional area and MGV of the EOM closest to the fracture compared to the same muscle in the unfractured orbit. This significance disappeared for some parameters on the second scan. The volume of herniated orbital contents was significantly smaller on the second scan than on the first.

Conclusions and significance: Based on the first longitudinal MRI study on patients with blowout fractures, our results indicate post-traumatic oedema in the intraorbital soft tissue which subsides between scans. A watchful waiting period is recommended in the initial post-traumatic days in patients without muscle entrapment.

Chinese abstract

背景：很少有研究注重老年人突发性感音神经性耳聋（ISSHL）的预后。

目的：本研究的目的是分析老年人ISSHL的特征、治疗和预后因素。

材料和方法：回顾性分析2014年至2019年间共278名老年人ISSHL患者。通过单变量和多变量逻辑分析来分析单变量。

结果：在13个单变量组中, 整体恢复组ORG患者的年龄较小（p = .018）, 而ORG的发病天数较短（p = .000）。 ORG中DM和HTN合并症的百分比较高（p = .026和.038）。同时, 听力图配置（p = .037）、听力损失程度（p = .033）和脂质治疗类型（p = .020）的差异显著。然后, 将这七个独立的危险因素纳入多变量分析, 最终结果表明高血压（p = .028）、脂质对照组（p = .009）、年龄（p = .000）和发病天数（p =.001）与ISSHL的治疗结果有关。

结论：老年ISSHL患者的预后与年龄、治疗起效天数、高血压和高脂血症等并发症的控制密切相关。因此, 血管因素被认为是发病的主要原因。

Keywords:

• Blowout fracture
• MRI
• oedema
• soft tissue

Disclosure statement

The authors report no conflicts of interest.