Surgical Treatment For Proptosis Triggered By Orbitofrontal Bone Lesions

Purpose: To describe surgical treatments of proptosis and ocular dystopia caused by bone lesions in orbitofrontal area and explore different measuring methods to evaluate postoperative outcome objectively.Methods: A retrospective analysis of patients with orbitofrontal bone lesions who received surgical treatment in our ward from 2015 to 2017.All patients undergone craniofacial 3-dimensional computed tomographic(3DCT)scanning,as well as preoperative and postoperative standardized photography.Measurements of proptosis and ocular dystopia were performed on CT images and photographs,respectively.Data collected from these measurements were analyzed statistically and used objectively to evaluate surgical outcomes.Results: 9 patients with unacceptable aesthetic appearance were treated.Mean difference of proptosis were reduced from(3.6±1.3)mm before the surgery to(1.6±0.8)mm,(0.6±0.5)mm,and(0.3±0.2)mm after the surgery(1 to 3 weeks,3 to 6months and 1 year,respectively).Variations between preoperative and all three postoperative proptosis measurements were all found to be statistically significant.Variations between 1 to 3 weeks and 3 to 6 months post-operation and between 1 to 3weeks and 1 year post-operation were found to be statistically significant.However,the variation between 3 to 6 months post-operation and 1 year post-operation was not statistically significant.Mean difference of ocular dystopia was reduced from(41.83±1.61)pixels before the surgery to(23.91±1.37)pixels,(8.31±1.08)pixels,and(7.46±1.14)pixels after the surgery(1 to 3 weeks,3 to 6 months and 1 year,respectively).Variations between preoperative and all three postoperative dystopia measurements were all found to be statistically significant.Conclusion: The present study demonstrated that surgical treatment of craniofacial bone lesions involving orbit could achieve acceptable results with no postoperative complications.Both proptosis measurement using CT scans and dystopia measurement using standard photography are objective,efficient,and accurate method that can be widely used in the clinical setting.Postoperative patients’satisfaction rates could be further elucidated with the integration of 3D stereophotogrammetric acquisition equipment on the facial area to achieve a more objective and precise comparison.