China Journal of Oral and Maxillofacial Surgery ›› 2026, Vol. 24 ›› Issue (5): 488-493.doi: 10.19438/j.cjoms.2026.05.008

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Evaluation of the application effect of intraoperative CT in the treatment of orbital wall fractures

Li Ailong1,2, Qiu Qingyuan1,2, Pang Chaoyuan1   

  1. 1. Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistics Support Force of PLA. Lanzhou 730050;
    2. Department of Oral and Maxillofacial Surgery, School of Stomatology, Lanzhou University. Lanzhou 730013, Gansu Province, China
  • Received:2025-09-30 Revised:2026-03-13 Online:2026-09-20 Published:2026-10-10

Abstract: PURPOSE: To investigate the application value of intraoperative computed tomography (iCT) in the surgical repair of orbital wall fractures. METHODS: Twenty-eight patients with unilateral orbital wall fractures admitted at the 940th Hospital of Joint Logistics Support Force of PLA from July 2023 to July 2025 were enrolled and randomly divided into the iCT group (n=14) and the conventional group (n=14). In the iCT group, iCT scanning (slice thickness: 0.625 mm) was performed before wound closure to evaluate fracture reduction and implant position; immediate adjustment was carried out in case of malreduction. The conventional group underwent surgery solely based on the surgeons' experience. Postoperative comparisons between the two groups included operation time, complication rate, improvement in enophthalmos, and orbital volume difference. RESULTS: The cohort was predominantly male (75.0%), with a mean age of 32.7 years. Road traffic accidents were the leading etiology (35.7%). Left-sided fractures were more common (60.7%), and zygomaticomaxillary complex fractures with periorbital involvement constituted 82.1% of the cases. Intraoperative adjustments based on iCT findings were required in 50% of the iCT group patients. At 6 months postoperatively, the improvement in enophthalmos [(2.7±1.4) mm] and the orbital volume difference [(997.9±445.6) mm3] in the iCT group were both superior to those in the traditional group, with no exacerbation of diplopia observed. CONCLUSIONS: Intraoperative CT enables real-time and accurate evaluation of orbital wall fracture reduction. It significantly improves postoperative orbital volume symmetry and enophthalmos correction, reduces the risk of aggravated diplopia, and has important clinical significance for enhancing the precision of complex orbital wall fracture repair.

Key words: Intraoperative CT, Orbital fractures, Blowout fractures, Orbital volume

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