Factors Influencing Postsurgical Diplopia in Orbital Floor Fractures and Prevalence of Other Complications in a Series of Cases.

Autor:	Gavin Clavero MA; Resident, Department of Oral and Maxillofacial Surgery, Miguel Servet University Hospital, Zaragoza, Spain. Electronic address: marinagvncla@gmail.com., Simón Sanz MV; Professor, Department of Oral and Maxillofacial Surgery, Miguel Servet University Hospital, Zaragoza, Spain., Til AM; Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Miguel Servet University Hospital, Zaragoza, Spain., Jariod Ferrer ÚM; Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Son Espases University Hospital, Mallorca, Spain.
Jazyk:	angličtina
Zdroj:	Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons [J Oral Maxillofac Surg] 2018 Aug; Vol. 76 (8), pp. 1725-1733. Date of Electronic Publication: 2018 Feb 19.
DOI:	10.1016/j.joms.2018.01.030
Abstrakt:	Purpose: We conducted a review of orbital fractures treated in our hospital over a period of 4 years. We reviewed several complications of such fractures, especially the relationship of postsurgical diplopia with different presurgical variables: age, gender, type of fracture, fracture area, coronal and sagittal diameter of fracture, fractured floor area, time to surgery, presence of muscle herniation, and presence of muscle entrapment. Patients and Methods: Fractures involving the orbital floor remain a controversial issue in terms of surgical treatment and the time from trauma to surgery. Surgical indications are divided into esthetic and functional, and they greatly differ from one medical center to another. We observed that the variables that influence postoperative complications varied in the different studies reviewed. Postsurgical diplopia is one of the most important complications, and its relationship with presurgical variables was the focus of this study. For the purpose of this study, we performed bivariate and multivariate analyses, accepting P < .05 as significant. Results: According to the multivariate analysis, postsurgical diplopia was only associated with trapdoor fractures, regardless of all other variables, especially if these fractures were operated on after 48 hours. In addition, the bivariate analysis showed that fractures involving muscle herniation resulted in less diplopia and a better prognosis if operated on before 48 hours. However, these results were not statistically significant. Conclusions: Surgery performed within 48 hours of trauma statistically improves fractures with true muscle entrapment and also, fractures with muscle hernation (although in this fractures, the improvement is not statistically significant). (Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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