Yong-Ha Kim1, Ju-Ho Ha, Tae-Gon Kim, Jun-Ho Lee. 1. Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Korea. yhkim@med.yu.ac.kr
Abstract
BACKGROUND: The purpose of this study was to retrospectively evaluate the patients who had undergone delayed correction of posttraumatic enophthalmos. METHODS: The medical charts of 85 patients with posttraumatic enophthalmos and who underwent surgical correction at the authors' medical center were reviewed. The outcomes were analyzed in relation to various factors such as the period of delayed correction, the causes of delayed correction, the type of initial injury, the pathologic site of the orbital wall, the operative methods, and the aesthetic and functional results. RESULTS: With regard to posttraumatic enophthalmos, good aesthetic and functional results were seen in most patients. The period from the initial injury up to the delayed correction ranged from 1 to 144 months (average, 20.9 months). The most common cause of posttraumatic enophthalmos was initial inadequate repair. A zygomatico-orbital fracture was initially the most frequent facial bone fracture. The most common defect site of the orbital wall was the inferior wall. Enophthalmos was significantly improved from a preoperative average of 3.16 mm to a postoperative average of 1.29 mm. CONCLUSIONS: Better functional results were achieved for the cases of mild to moderate enophthalmos with a single defect site of the orbital wall for the patients without associated facial bone fracture. We conclude that most cases of posttraumatic enophthalmos could be prevented through careful reconstruction during the first operation. Delayed correction of posttraumatic enophthalmos could be a possible reparative procedure if sufficient release of scar tissue, accurate repositioning of the dislocated orbital bones, and proper intraorbital grafting are performed.
BACKGROUND: The purpose of this study was to retrospectively evaluate the patients who had undergone delayed correction of posttraumatic enophthalmos. METHODS: The medical charts of 85 patients with posttraumatic enophthalmos and who underwent surgical correction at the authors' medical center were reviewed. The outcomes were analyzed in relation to various factors such as the period of delayed correction, the causes of delayed correction, the type of initial injury, the pathologic site of the orbital wall, the operative methods, and the aesthetic and functional results. RESULTS: With regard to posttraumatic enophthalmos, good aesthetic and functional results were seen in most patients. The period from the initial injury up to the delayed correction ranged from 1 to 144 months (average, 20.9 months). The most common cause of posttraumatic enophthalmos was initial inadequate repair. A zygomatico-orbital fracture was initially the most frequent facial bone fracture. The most common defect site of the orbital wall was the inferior wall. Enophthalmos was significantly improved from a preoperative average of 3.16 mm to a postoperative average of 1.29 mm. CONCLUSIONS: Better functional results were achieved for the cases of mild to moderate enophthalmos with a single defect site of the orbital wall for the patients without associated facial bone fracture. We conclude that most cases of posttraumatic enophthalmos could be prevented through careful reconstruction during the first operation. Delayed correction of posttraumatic enophthalmos could be a possible reparative procedure if sufficient release of scar tissue, accurate repositioning of the dislocated orbital bones, and proper intraorbital grafting are performed.