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Radiographic Predictors of FACE-Q Outcomes Following Non-Operative Orbital Floor Fracture Management.

Kyle Gabrick1, John Smetona1, Rajiv Iyengar1

  • 1Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine.

The Journal of Craniofacial Surgery
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PubMed
Summary

Inferior rectus muscle rounding on CT scans predicts psychosocial distress after orbital floor fractures. This finding aids in managing these common facial injuries and improving patient outcomes.

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Area of Science:

  • Ophthalmology
  • Plastic Surgery
  • Radiology

Background:

  • Orbital floor fractures are common, with ongoing debate about surgical indications.
  • This study investigates the link between radiographic features and patient-reported outcomes in non-operatively managed fractures.

Purpose of the Study:

  • To correlate radiographic characteristics of orbital floor fractures with validated patient-reported outcome measures.
  • To identify specific radiographic findings predictive of long-term patient satisfaction and distress.

Main Methods:

  • Retrospective review of 18 patients with orbital floor fractures managed non-operatively.
  • Analysis of CT scans, demographic data, and FACE-Q outcomes (Satisfaction with Eyes, Psychological Function, Social Function, Appearance Related Psychosocial Distress).
  • Statistical analysis to identify significant predictors of patient-reported outcomes.

Main Results:

  • Inferior rectus muscle rounding was a significant predictor of appearance-related psychosocial distress (P = 0.006).
  • Severe rounding correlated with larger fracture areas, greater maxillary sinus displacement, and worse psychosocial distress.
  • Mean follow-up was 3.6 years, with 61% attending clinic appointments.

Conclusions:

  • Inferior rectus muscle belly rounding on imaging is significantly associated with appearance-related psychosocial distress.
  • This radiographic finding is valuable for guiding management decisions in orbital floor fractures.
  • This study is the first to use validated patient-reported questionnaires to assess long-term outcomes after orbital floor fractures.