Intraoperative Computed Tomography Scan for Orbital Fracture Reconstruction

Abd Jabar Nazimi, Soo Ching Khoo, Syed Nabil, Rifqah Nordin, Tan Huann Lan, Rama Krsna Rajandram, Jothi Raamahlingam Rajaran

Research output: Contribution to journalArticle

Abstract

Orbital fractures pose specific challenge in its surgical management. One of the greatest challenges is to obtain satisfactory reconstruction by correct positioning of orbital implant. Intraoperative computed tomography (CT) scan may facilitate this procedure. The aim of this study was to describe the early use of intraoperative CT in orbital fractures repair in our center. The authors assessed the revision types and rates that have occurred with this technique. With the use of pre-surgical planning, optical intraoperative navigation, and intraoperative CT, the impact of intraoperative CT on the management of 5 cases involving a total number of 14 orbital wall fractures were described. There were 6 pure orbital blowout wall fractures reconstructed, involving both medial and inferior wall of the orbit fracturing the transition zone and 8 impure orbital wall fractures in orbitozygomaticomaxillary complex fracture. 4 patients underwent primary and 1 had delayed orbital reconstruction. Intraoperative CT resulted in intraoperative orbital implant revision, following final navigation planning position, in 40% (2/5) of patients or 14% (2/14) of the fractures. In revised cases, both implant repositioning was conducted at posterior ledge of orbit. Intraoperative CT confirmed true to original reconstruction of medial wall, inferior wall and transition zone of the orbit. Two selected cases were illustrated. In conclusion, intraoperative CT allows real-time assessment of fracture reduction and immediate orbital implant revision, especially at posterior ledge. As a result, no postoperative imaging was indicated in any of the patients. Long-term follow-ups for orbital fracture patients managed with intraoperative CT is suggested.

Original languageEnglish
Pages (from-to)2159-2162
Number of pages4
JournalThe Journal of craniofacial surgery
Volume30
Issue number7
DOIs
Publication statusPublished - 1 Oct 2019

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Orbital Fractures
Tomography
Orbital Implants
Orbit
Fracture Fixation
Case Management

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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Intraoperative Computed Tomography Scan for Orbital Fracture Reconstruction. / Nazimi, Abd Jabar; Khoo, Soo Ching; Nabil, Syed; Nordin, Rifqah; Lan, Tan Huann; Rajandram, Rama Krsna; Rajaran, Jothi Raamahlingam.

In: The Journal of craniofacial surgery, Vol. 30, No. 7, 01.10.2019, p. 2159-2162.

Research output: Contribution to journalArticle

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