Surgical timing of the orbital "blowout" fracture: A systematic review and meta-analysis

TY - JOUR

T1 - Surgical timing of the orbital "blowout" fracture

T2 - A systematic review and meta-analysis

AU - Damgaard, Olaf Ehlers

AU - Larsen, Christian Grønhøj

AU - Felding, Ulrik Ascanius

AU - Toft, Peter Bjerre

AU - Von Buchwald, Christian

PY - 2016/9

Y1 - 2016/9

N2 - Objective: The orbital blowout fracture is a common facial injury, carrying with it a risk of visual impairment and undesirable cosmetic results unless treated properly. Optimal timing of the surgical treatment is still a matter of debate. We set out to determine whether a meta-analysis would bring us closer to an answer to this question. Data Sources: PubMed, EMBASE, Web of Science, and the Cochrane Library were searched from January 1980 to August 2014. We applied the following inclusion criteria: isolated blowout fractures, presenting early and late surgery groups (<14 and >14 days). Patients were evaluated for diplopia and enophthalmos. Review Methods: We followed the statements of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Pooled odds ratios were estimated with the fixed effects method of Mantel-Haenszel. Results: We identified 5 studies with available outcome data (N = 442). Patients in the late group showed an odds ratio of 3.3 (P =.027) for persistent postoperative diplopia as compared with the early group. We found no significant difference between the groups when assessing postoperative enophthalmos as an isolated symptom. Conclusion: We found a significantly increased risk of persistent diplopia in patients who were operated >14 days after the trauma.

AB - Objective: The orbital blowout fracture is a common facial injury, carrying with it a risk of visual impairment and undesirable cosmetic results unless treated properly. Optimal timing of the surgical treatment is still a matter of debate. We set out to determine whether a meta-analysis would bring us closer to an answer to this question. Data Sources: PubMed, EMBASE, Web of Science, and the Cochrane Library were searched from January 1980 to August 2014. We applied the following inclusion criteria: isolated blowout fractures, presenting early and late surgery groups (<14 and >14 days). Patients were evaluated for diplopia and enophthalmos. Review Methods: We followed the statements of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Pooled odds ratios were estimated with the fixed effects method of Mantel-Haenszel. Results: We identified 5 studies with available outcome data (N = 442). Patients in the late group showed an odds ratio of 3.3 (P =.027) for persistent postoperative diplopia as compared with the early group. We found no significant difference between the groups when assessing postoperative enophthalmos as an isolated symptom. Conclusion: We found a significantly increased risk of persistent diplopia in patients who were operated >14 days after the trauma.

KW - blowout

KW - fracture

KW - orbital

KW - surgical

KW - timing

U2 - 10.1177/0194599816647943

DO - 10.1177/0194599816647943

M3 - Review

C2 - 27165680

AN - SCOPUS:84984916659

SN - 0194-5998

VL - 155

SP - 387

EP - 390

JO - Otolaryngology - Head and Neck Surgery

JF - Otolaryngology - Head and Neck Surgery

IS - 3

ER -