Rounding of the inferior rectus muscle as an indication of orbital floor fracture with periorbital disruption.
OBJECTIVE
To determine if rounding of the inferior rectus muscle on coronal computed tomographic (CT) scans predicts disruption of the periorbita in orbital floor fractures and therefore predicts delayed enophthalmos.


METHODS
Cadaveric study with CT scan analysis.


METHODS
Cadaveric laboratory and CT scanner at a tertiary care hospital in London, Ontario.


METHODS
Each orbit of each cadaveric head was randomly assigned to have either intact or disrupted periorbita. Progressively larger orbital floor fractures were made and CT scans were taken before fractures and after each fracture to assess the shape of the inferior rectus muscle. Measurements were made of the length of the long and short axis of the inferior rectus muscle using CT analysis software. The short to long axis ratio was then compared.


METHODS
Change in the short to long axis ratio of the inferior rectus muscle and correlation of the ratio with intact and disrupted periorbita.


RESULTS
Orbital floor fractures measuring 1 x 1 cm show an increase in the short to long axis ratio (rounding) of the inferior rectus muscle only if the periorbita is disrupted. Orbital floor fractures measuring 2 x 2 cm show rounding of the inferior rectus muscle regardless of whether the periorbita is intact or disrupted; however, the degree of rounding is greater if the periorbita is disrupted.


CONCLUSIONS
For small orbital floor fractures, rounding of the inferior rectus muscle predicts periorbital disruption. This may therefore represent an indication for early surgical repair to prevent delayed enophthalmos.
Banerjee
Avik
A
Department of Otolaryngology-Head and Neck Surgery, The University of Western Ontario, London, Ontario, Canada. banerjee.avik@gmail.com
Moore
Corey C
CC
Tse
Raymond
R
Matic
Damir
D
D015841:Enophthalmos / Q000209:etiology; D006801:Humans; D009917:Orbital Fractures / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D011237:Predictive Value of Tests; D017568:Rectus Abdominis / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed