Page 62 - Advanced concepts in orbital wall fractures

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Chapter 3
exophthalmometry of the patients was not possible. In future studies, it might be interesting to relate orbital volume to exophthalmometry.
The results of this study show that the unaffected contralateral orbital cavity can be used as a starting point for orbital reconstruction. The mirroring tool is a legitimate first step in planning, provided the facial skeleton is carefully examined for pre-existing asymmetries and bearing in mind the small variations in symmetry that might be present. This tool is useful in a clinical setting for preoperative planning and to check the result of the surgical reconstruction. It supplies the surgeon with essential information on the reconstruction of the orbital defect, with or without the use of an implant.
Left-versus-right differences in volume in unaffected human orbital cavities are small, with a mean difference of 0.44 mL, corresponding to 1.6 % of the total volume of the orbit. Compared with other studies, the differences are similar or slightly less in volume. The overall symmetry seems to be accurate. Based on these limited variations in orbital volume and contour, the use of the mirroring technique for orbital reconstruction in unilateral affected orbits is legitimate. This makes it a valuable first step in preoperative planning as part of CAS. However, although accurate restoration of orbital volume is a primary goal, posttraumatic changes of orbital soft tissue can still affect the final aesthetic and functional outcome. Future studies should focus on the advantages of this mirroring technique for clinical outcome and complication rates.