Author(s)
Tyler M. Rist MD
Katherine Gossett MD
Elizabeth Walker MD
Krishna Patel MD, PhD
Affiliation(s)
Department of Otolaryngology at the Medical University of South Carolina;
Abstract:
Background:
Achieving satisfactory results related to orbit position after midface reconstruction has historically been difficult. Previous recommendations have focused on the importance of accurate bony reconstruction.
Learning
Objectives:
Critically evaluate the most important factors in orbital reconstruction.
Study
Objective:
Provide further insight into the critical aspects of orbital and midface reconstruction.
Design Type:
Retrospective review from 2011-2021 at a tertiary referral academic medical center.
Method:
The medical record was queried after obtaining IRB approval, and a comprehensive chart review was performed. Included patients were required to have a portion of the inferior orbital rim resected and have appropriate post-operative photographs and CT scans for review. Bony measurements were taken from the CT scans. Standardized measurements were taken from photographs using the averages from three different healthcare providers. The reconstructed orbit was compared to the contralateral side and correlations were performed between the CT and photographic measurements.
Results:
Eight patients met inclusion criteria. Measurements of the reconstructed bony orbit varied minimally from the non-operated orbit (range of 1.20 to 2.71 mm and average volume of 1.31 cm3). Fifty-two correlations performed between CT and photographic measurements were not significant. Two correlations were found to be significant but had minimal, if any, clinical application. 88% of patients had to undergo additional procedures for orbit related issues.
Conclusions:
In this group of patients, measurements of bony orbital reconstruction did not translate into clinically meaningful post-operative soft tissue outcomes. Despite accurate bony reconstruction within millimeters, all the patients still required surgical revision highlighting the difficultly of this reconstruction.