Factors Influencing Outcome of Orbital Floor Reconstruction

Sony Prakkattumannathu Varghese; Jonathan Victor; Sharad Ramdas; P P Lingam; Hannah Ranjee Prasanth; Vijay Jaganathan; Dinesh Kumar

doi:10.1055/s-0043-1769110

Factors Influencing Outcome of Orbital Floor Reconstruction

Indian J Plast Surg. 2023 Jun 1;56(4):326-331. doi: 10.1055/s-0043-1769110. eCollection 2023 Aug.

Authors

Sony Prakkattumannathu Varghese¹, Jonathan Victor², Sharad Ramdas³, P P Lingam², Hannah Ranjee Prasanth⁴, Vijay Jaganathan², Dinesh Kumar²

Affiliations

¹ Department of Plastic and Reconstructive Surgery, Khawlah Hospital, Muscat, Oman.
² Department of Plastic Surgery, Pondicherry Institute of Medical Sciences, Pondicherry, India.
³ Department of Plastic and Reconstructive Surgery, Flinders Medical Center, Bedford, Australia.
⁴ Department of Ophthalmology, Pondicherry Institute of Medical Sciences, Pondicherry, India.

Abstract

Introduction Orbital floor fractures are routinely encountered in facial trauma. Many factors influence the final outcome of the orbital floor surgery, time interval and the extent of other facial bone fractures are the two factors which can significantly influence the postoperative outcome following orbital floor reconstruction. Our study aims to find the ideal time for intervention and the association of other factors in the final outcome of orbital floor reconstruction. Methods A retrospective and prospective cohort study of patients who were operated at Pondicherry Institute of Medical Sciences for orbital floor fractures, between 2011 January and 2017 July. All the data were entered on an Excel work sheet and statistically analyzed. Results In our study 8 patients (8/29, 27.58%) had diplopia prior to surgery, 5 patients (5/29, 17.24%) had complete recovery following surgery and 3 patients (3/29, 10.34%) had persistence of diplopia postoperatively. Patients with diplopia operated prior to 7 days were found to have significant improvement in postoperative diplopia. Patients with 5 or more facial fractures were found to have persistence of diplopia, infraorbital numbness, and enophthalmos postoperatively. Conclusion Our study suggests that early intervention, before 7 days improves the outcome in patients with diplopia and provides a better result postoperatively. In our study preoperative diplopia and infraorbital numbness and postoperative persistence of enophthalmos, diplopia, and paresthesia were found more in patients with 5 or more facial bone fractures. Our study suggests a poor postoperative outcome when 5 or more facial bones are fractured.

Keywords: diplopia; enophthalmos; fracture intervention timing; orbital floor fracture; orbital fracture score.

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