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J Neurol Surg B Skull Base 2022; 83(03): 281-284
DOI: 10.1055/s-0040-1721821
Original Article

Pediatric Orbital Roof Fractures: A Ratio of Orbital Dimensions Correlated to Prevalence of Fracture

Stephen C. Dryden 
1   Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee, United States
,
Andrew G. Meador
1   Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee, United States
,
Andrew B. Johnston
1   Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee, United States
,
Adrianna E. Eder
1   Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee, United States
,
James C. Fleming
2   Department of Ophthalmology, Veterans Administration Hospital, Memphis, Tennessee, United States
,
Brian Fowler
1   Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee, United States
› Author Affiliations Funding This study was supported by an unrestricted grant from Research to Prevent Blindness.
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Abstract

Objective Orbital roof fractures are more likely to occur in younger children, specifically younger than 7 years. Cranium to face ratio decreases with age; however, there is no definition for measurement of the neurocranium or face. We propose using the length of the orbital roof as a measurement of the neurocranium and length of the orbital floor as a tool to estimate midface size. The purpose of this study is to test this measurement as a correlation rate of orbital roof fractures within the pediatric population.

Design This is a retrospective study.

Setting This study was done at the LeBonheur Children's Hospital.

Participants Sixty-six patients with orbital roof fractures were identified and stratified by gender and age, specifically younger than 7 years and 7 years or older.

Main Outcome Measures The main outcome measures were orbital roof length, floor length, and ratio thereof.

Results Mean orbital roof length was 43.4 ± 3.06 and 45.1 ± 3.94 mm for patients <7 and ≥7 years, respectively (p = 0.02). Mean orbital floor length was 41.3 ± 2.99 and 47.7 ± 4.19 for patients <7 and ≥7 years, respectively (p < 0.00001). The mean roof to floor ratio (RTFR) for patients <7 years was 1.051 ± 0.039 and for patients ≥ 7 years was 0.947 ± 0.031 (p < 0.00001).

Conclusion As children age, the relative length of the orbital roof decreases when compared with the orbital floor. The RTFR was more than 1.0 in children younger than 7 years. These differences were statistically significant when compared with children 7 years and older. This measurement shift follows the differences noted in orbital fracture patterns during childhood.

Keywords

orbital roof fracture - pediatric - trauma - pediatric orbital fracture - craniofacial - skull - orbit development - measurement correlate

Note

The preliminary data was presented at 30th Annual North American Skull Base Society Meeting 2020 in San Antonio, Texas, United States.




Publication History

Received: 24 March 2020

Accepted: 25 September 2020

Article published online:
14 December 2020

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