title: [Posttraumatic enophthalmos correction by bone graft: Why the unpredictable results?].
abstract: OBJECTIVE
  Posttraumatic enophthalmos cause complex cosmetic problems to fix. In order to get better results, we wanted to calculate the volume of parietal bone graft needed to be put in place, know where to place it in orbit and study soft tissues' participation.
  
  
  METHODS
  In a retrospective study, we have calculated on scanner the volume of bone and soft tissue as well as the volume and the location of the graft. We have compared, between two groups ("good result" and "insufficient result"), graft volumes, taking into account differences in bone's volume between the healthy and the traumatized orbit. A comparison of the locations of the graft was also made. We were trying to find out if these factors were involved in the quality of the result.
  
  
  RESULTS
  Twenty-nine surgeries on 24 patients were analyzed. The average bone's volume of an orbit with enophthalmos was 24.76 cm(3) for 17.12 cm(3) of soft tissue. Retro-lens distance was the most reliable measurement method of enophthalmos (P=0.001). There was a trend to a more substantial over-correction in the group "good result". A significant increase (P=0.0008) of soft tissue volumes in the traumatized orbit was found.
  
  
  CONCLUSIONS
  This last result is surprising. Many authors believe that there is a scar retraction of soft tissues. But Kronish et al. showed an increase of the fat density and connective tissue. This, together with the assumption of a weathering of the ligament suspension of the globe, may affect our aesthetic results. MRI, ultrasound and anatomopathological studies would allow a better understanding of the fat, muscle and ligament pathophysiologies of an orbit with enophthalmos.
authors.affiliation: Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France. Electronic address: audreymoret@hotmail.fr.
authors.forename: A
authors.initials: A
authors.lastname: Moret
authors.affiliation: Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France.
authors.forename: A
authors.initials: A
authors.lastname: Paré
authors.affiliation: Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France.
authors.forename: F
authors.initials: F
authors.lastname: Sury
authors.affiliation: Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France.
authors.forename: D
authors.initials: D
authors.lastname: Goga
authors.affiliation: Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France.
authors.forename: B
authors.initials: B
authors.lastname: Laure
mesh_terms: D000328:Adult; D015841:Enophthalmos / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009917:Orbital Fractures / Q000150:complications; D010294:Parietal Bone / Q000637:transplantation*; D017060:Patient Satisfaction; D012189:Retrospective Studies
keywords: Bone graft; Enophthalmos; Greffe osseuse; Mesure de volume; Posttraumatic; Traumatique; Volume measurement; Énophtalmie