University of Twente Student Theses
Advancements in the classification of orbital fractures
Pilon, A.J.M. (2024) Advancements in the classification of orbital fractures.
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| Abstract: | Purpose: Fractures of the orbit are one of the most common midfacial fractures. Unfortunately, they present challenges in consistent identification due to the complex anatomy of the orbit and variability in injury patterns. The diagnosis of orbital fractures frequently faces inconsistencies due to the reliance on subjective radiological evaluations and two-dimensional imaging from existing classification systems. This thesis proposes a semi-automated method to achieve consistent localization and quantification of orbital fractures. By integrating advanced imaging techniques, objective measurement tools, and automating the current classification system, this innovative approach seeks to minimize subjectivity in the diagnostic process of orbital fractures. Method: This thesis introduces two semi-automated methodologies for the radiological evaluation of orbital fractures. The first method is designed to quantify the extent of an orbital fracture, while the second focuses on its localization within the orbit's anterior, mid, or posterior region. The quantification methodology employs a technique to align both unaffected and affected orbits, allowing for precise measurement and delineation of fractures. Meanwhile, the localization methodology introduces the innovative concept of establishing a 'true orbital axis,' which systematically divides the orbit into distinct regions. Together, these methodologies form the fundament of the automatic classification of orbital fractures in accordance with the Jaquiéry classification system. The evaluation of this novel approach includes consistency checks of the semi-automatic methods and comparative analyses with traditional methods, showcasing its potential to enhance the accuracy and reliability of orbital fracture diagnosis. Results: The validation of the semi-automatic methods for assessing orbital fractures revealed no systematic errors, indicating the adequacy of this approach. The analysis of 30 orbital fractures showed an average defect area of 259.5 ± 146.0 mm², with a tendency for fractures to affect the anterior and mid regions. The use of automatic classification demonstrated an increase in average surface area from Class I through Class IV fractures. Comparative analyses between fractures classified using this novel approach and those assessed by the conventional methods underscored the subjectivity present in existing radiological evaluations of orbital fractures. Coclusion: This study introduces and validates an innovative semi-automatic method for the three-dimensional identification of orbital fractures, allowing for precise quantification of each third of the fractured area, independent of subjective observer interpretations. By incorporating a key anatomical parameter—the bony medial margin of the intraorbital fissure—this method supports the automatic categorization of fractures according to the Jaquiéry system. Consequently, it is advocated for implementation in clinical practice, providing a tool for a more standardized and objective assessment of orbital fractures. |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/98706 |
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