Factors influencing post-surgical diplopia in orbital floor fractures and prevalence of other complications in a serie of cases

Publication date: Available online 19 February 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Marina Alexandra Gavin Clavero, M Victoria Simón Sanz, Andrea Mur Til, Úrsula María Jariod Ferrer
PurposeWe have conducted a review of the orbital fractures treated in our hospital for a period of four years. We have reviewed its several complications, and especially the relationship of postsurgical diplopia with different pre-surgical variables: age, sex, type of fracture, fracture area, coronal and sagittal diameter of the fracture, fractured floor area, time to surgery, existence of muscular herniation and muscle entrapment.Patients and methodsFractures involving the orbital floor still remain a controversial issue in terms of surgical treatment and the time required from trauma to surgery. Surgical indications are divided into aesthetic and functional, and they greatly differ from one medical center to another. It has been observed that the variables that influence postoperative complications vary in the different studies reviewed. Post-surgical diplopia is one of the most important complications, and its relationship with pre-surgical variables has been the focus of this study. For the purpose of the present study, a bivariate and a multivariate analysis has been performed, accepting as significant the value p <0.05.Resultsaccording to the multivariate analysis, post-surgical diplopia is only associated with trap door fractures, regardless of all other variables, especially if these fractures are operated after 48 hours. In addition, the bivariate analysis has also reported that fractures involving muscular herniation result in less diplopia and a better prognosis if operated before 48 hours. Notwithstanding, these results are not statistically significant.ConclusionSurgery before 48 hours statistically improves fractures with real muscular entrapment, and improves (although not statistically significantly) patients with muscular herniation.



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