Secondary Post-Traumatic Enophthalmos: High-Resolution Magnetic Resonance Imaging Compared With Multislice Computed Tomography in Postoperative Orbital Volume Measurement

Kolk, Andreas; Pautke, Christoph; Schott, Verena; Ventrella, Ester; Wiener, Edzard; Ploder, Oliver; Horch, Hans Henning; Neff, Andreas

doi:10.1016/j.joms.2006.06.269

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 10 , Pages 1926-1934, October 2007

Secondary Post-Traumatic Enophthalmos: High-Resolution Magnetic Resonance Imaging Compared With Multislice Computed Tomography in Postoperative Orbital Volume Measurement

Andreas Kolk, MD, DDS, PhD
- Senior Consultant, Department of Oral and Maxillofacial Surgery, University of Technology of Munich, Munich, Germany.
- Address correspondence and reprint requests to Dr Kolk: Department of Oral and Cranio-Maxillofacial Surgery, University of Technology of Munich, Ismaninger Str 22, D-81675 Munich, Germany
Christoph Pautke, MD, DDS
- Resident, Department of Oral and Maxillofacial Surgery, University of Technology of Munich, Munich, Germany.
Verena Schott, MD
- Resident, Department of Diagnostic Radiology, University of Technology of Munich, Munich, Germany.
Ester Ventrella, MD
- Resident, Department of Diagnostic Radiology, University of Technology of Munich, Munich, Germany.
Edzard Wiener, MD
- Resident, Department of Diagnostic Radiology, University of Technology of Munich, Munich, Germany.
Oliver Ploder, MD, DDS, PhD
- Professor and Head, Department of Oral and Maxillofacial Surgery, Landeskrankenhaus Feldkirch, Feldkirch, Austria.
Hans Henning Horch, MD, DDS, PhD
- Professor and Head, Department of Oral and Maxillofacial Surgery, University of Technology of Munich, Munich, Germany.
Andreas Neff, MD, DDS, PhD
- Senior Consultant, Department of Oral and Maxillofacial Surgery, University of Technology of Munich, Munich, Germany.

Purpose

Multislice computed tomography (MSCT) was the modality of choice for orbital volume measurement. This first prospective study compares MSCT with high-resolution magnetic resonance imaging (MRI) combined with micro (MRImc) and headcoil (MRIhc) in volumetric evaluation of the postsurgical enophthalmic orbit.

Patients and Methods

Morphologic and dimensional changes of the orbit, eyebulb, and fat content were investigated 3 to 4 months after reconstruction of complex orbital fractures in 36 patients. Image analysis and volumetric assessment from 2-dimensional and 3-dimensional-MRImc and MRIhc were compared with MSCT. The volume segmentation algorithm operated on multispectral, 3-dimensional MR data acquired at isotropic proton density weighted acquisitions.

Results

CT and MRI volume data correlated significantly (P < .01). Enlargement of the posterior segment often resulted in orbital geometry change from conical to convex. Even cases of correct orbital reconstruction presented significant volume enlargement compared to the contralateral side (P < .01). The retro bulbar fat showed itself fragmented and was dislocated in the medial posterior region mostly. We found reduced sagittal eye projection, increased width of the orbital rim, and dislocation of the posteromedial orbital floor (P < .01). High correlation was detected between orbital volume increment and degree of enophthalmos (0.93 mm per 1 cm³ orbital volume enlargement diameter) (P < .01).

Conclusions

As MRI orbital volume measurement permitted prediction of postsurgical enophthalmos, which is related to possible failure in orbital volume correction and reduction of the posterior medial bulge and not to fat content changes, it is suited for planning secondary correction.