DOI: https://doi.org/10.22263/2312-4156.2024.6.106
A.N. Mikhaylov1, Yu.N. Patupchik1,2
X-ray diagnosis of traumatic injuries to the orbit lower wall
1The Institute for Advanced Training & Retraining of Healthcare Personnel of the Educational Institution “Belarusian State Medical University”, Minsk, Republic of Belarus
2Healthcare Institution “The 10th City Clinical Hospital”, Minsk, Republic of Belarus
Vestnik VGMU. 2024;23(6):106-114.
Abstract.
Objectives. To optimize of the method of computed tomographic visualization of traumatic orbital injuries and to improve the protocol description to reflect diagnostically significant criteria necessary for predicting the choice of treatment tactics and patients’ management.
Material and methods. Plain radiography, multislice computed tomography.
Results. For visualization, radiation (using ionizing radiation) diagnostic methods were used. All patients underwent skull imaging in the anterior direct and lateral projections and multispiral computed tomography in the axial plane with image reconstruction in the frontal and sagittal planes. 108 patients with combined injuries of the facial bones and orbital structures were clinically examined. Of the 108 injured patients, the majority of patients n=56 (51.9%) were injured as a result of road traffic accidents, followed by domestic injuries (21 patients (19.4%)). Fractures of the inferior wall of the orbit were found in all patients (n=108; 100%), medial wall – 66 patients (61.1%), isolated fracture of the inferior wall was found in 42 patients (38.9%), the injuries were of a combined nature. The diagnostic efficiency of methods of radiation visualization of the orbit in patients with orbital trauma at the preoperative stage was Se= 55.1%, Sp=46.1% for radiography of bone structures; Se= 96.3%, Sp=93.75% for MSCT. MSCT is the most informative and promising method for diagnosing injuries of the eye and orbital structures, especially for calculating the dimensional and geometric parameters of bone defects, which allows for more accurate prediction of the consequences of the orbit traumatic damage, more precise planning of the extent of surgical intervention, if necessary, assessing the condition of the orbit after the surgical procedure.
Keywords: fractures of the inferior wall of the orbit, radiography, multislice computed tomography, size of the bone defect, fracture surface area, burst fracture.
References
1. Avetisova SE, Egorova EA, Moshetovoy LK, Neroeva VV, Takhchidi KhT, red. Ophthalmology: nats ruk. Moscow, RF: GEOTAR-Media; 2011. 944 р. (In Russ.)
2. Bakushev AP, Sivolapov KA. Surgical treatment of patients with isolated ocular wall fractures. Oftal’mologiya. 2015;12(3):48-53. (In Russ.). doi: http://dx.doi.org/10.18008/1816-5095-2015-3-48-53
3. Nikolaenko VP, Astakhov YuS. Orbital fractures: ruk dlya vrachei. St. Petersburg, RF: Eko-Vektor; 2012. 436 р. (In Russ.)
4. Abdulkerimov TKh, Mandra YuV, Gerasimenko VI, Tsekh DV, Samatov NR, Mandra EV, i dr. Epidemiology of orbital wall fractures. A retrospective study. Problemy Stomatologii. 2019;15(2):46-49. (In Russ.)
5. Davydov DV, Levchenko OV, Mikhaylyukov VM. Reconstructive surgery of posttraumatic defects and deformities of the eye socket using intraoperative frameless navigation. Vestn Oftal’mologii. 2014;130(2):20-26. (In Russ.)
6. Amosov VI, Speranskaya AA, Lukina OV. Use of multispiral computed tomography (MSCT) in ophthalmology. Oftal’mol Ved. 2008;1(3):54-56. (In Russ.)
7. Mikhaylov AN, Dudich ON, Patupchik YuN. Radial imaging of the orbit in normal and traumatic injuries. Nerazrushayushchii Kontrol’ Diagnostika. 2019;(4):40-56. (In Russ.)
8. Mikhaylov AN, Patupchik YuN, Dudich ON. Radial imaging of the orbit in norm, in traumatic injuries and its significance in planning surgical intervention. Zdravookhranenie. 2020;(5):7-27. (In Russ.)
9. Mikhailov AN, Dudich ON, Patupchik YuN. Possibilities of using multispiral computed tomography in visualization of posttraumatic defects of the inferior wall of the eye socket. V: Mikhailov AN, red. Luchevaya vizualizatsiya zabolevanii skeleta i vnutrennikh organov: sb nauch rabot, posvyashch 125-letnemu yubileyu otkrytiya rentgen izlucheniya. Minsk, RB: BelMAPO; 2020. Р. 121-123. (In Russ.)
10. Mikhaylov AN, Patupchik YuN, Dudich ON. Radial imaging and classification of blast (blow-out) fractures of the inferior wall of the orbit. V: M-vo zdravookhraneniya Resp Belarus’; Mikhailov AN, red. Luchevaya vizualizatsiya zabolevanii skeleta i vnutrennikh organov: sb nauch rabot, posvyashch 85-letnemu yubileyu akad NAN Belarusi AN Mikhailova i 70-letiyu kaf luchevoi diagnostiki BelMAPO, Minsk, 26 iyunya 2021 g. Minsk, RB: BelMAPO; 2021. Р. 60-67. (In Russ.)
11. Gorbachev DS, Kulikov AN, Danilichev VF. Damage to the eye socket. V: Danilichev VF, Kulikov AN, red. Sovremennaya oftal’mologiya: rukovodstvo. 3-e izd, pererab i dop. Sankt-Peterburg, RF; 2021. Gl 13. Р. 429-487. (In Russ.)
Submitted 19.09.2024
Accepted 04.12.2024
Information about authors:
A.N. Mikhaylov – Doctor of Medical Sciences, Professor, Academician of Medicine of the National Academy of Sciences of Belarus, head of Chair of Radiation Diagnostics, Institute for Advanced Training & Retraining of Healthcare Personnel of the Educational Institution “Belarusian State Medical University”;
Yu.N. Patupchik – senior lecturer of the Chair of Radiation Diagnostics, Institute for Advanced Training & Retraining of Healthcare Personnel of the Educational Institution “Belarusian State Medical University”; doctor of the highest qualification category, head of the X-ray department, Healthcare Institution “The 10th City Clinical Hospital” in Minsk;
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Yulia Nikolaevna Patupchik.
