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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Rivista Italiana di Chirurgia Maxillo-Facciale 2003 August;14(2):63-8
Post-traumatic cosmetic deformities of the midface. Evaluation of post-traumatic post-surgical enophthalmos
D’Angelo R. 1, Santamaria S. 2, Marasco M. 2, Romano F. 2, Albanese M. 2, De Ponte F. S. 2
1 Department of Ophthalmology “G. Martino” Polyclinic University of Messina, Messina, Italy
2 Department of Maxillo-Facial Surgery “G. Martino” Polyclinic University of Messina, Messina, Italy
Aim. In this paper, the authors study the degree of post-surgical post-traumatic enophthalmos, by means of Hertel’s exophthalmometer, in a sample of patients suffering from orbital-zygomatic fractures who were treated using different reconstruction methods. Results are compared with the data reported in the literature.
Methods. A homogeneous sample of 30 patients has been studied. Pre-operative evaluation is based on the use of both radiological, such as volumetric CT, and instrumental, such as Hertel’s exophthalmometer, methods in order to determine the fracture site and the severity of the clinical situation. These 2 elements underlie the surgical plan which aims to reconstruct orbital volume and position the globe correctly.
Results. After these treatment methods, we noted that residual post-surgical diplopia was absent, while post-surgical enophthalmos was limited to 30% of patients (9 patients); 16.6% (5 patients) out of 30% had an enophthal-mos of less than 1 mm and 13.4% (4 patients) had an enophthalmos of less than 0.5 mm. We observed 24 patients (80%) with preoperative diplopia only, and 3 (10%) patients with pre and postoperative diplopia.
Conclusion. A total recovery of the globe position compared to the orbital frame is very difficult to achieve. So, if we agree that a residual enophthalmos can be considered a normal sequence for post-traumatic reconstruction of the orbital volume, it’s right to plan surgery which takes into account a conceptually constant but variable coefficient of hypercorrection, if we want to try to minimize the post-traumatic post-surgical enophthalmos.