New research featuring Disior™ CMF Orbital

“Computer-aided method significantly facilitates the systematic evaluation of bone fragments, and the extent of orbital fractures.”

Pyötsiä K., Lehtinen V., Toivari M., Puolakkainen T., Lowery Wilson M., Snäll J. (2021). Three-dimensional computer-aided analysis of 293 isolated blowout fractures – which radiological findings guide treatment decision? Journal of Oral and Maxillofacial Surgery. DOI: https://doi.org/10.1016/j.joms.2021.06.026

Researchers from the Helsinki University Hospital, the University of Helsinki, and Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University investigated the factors associated with the choice of treatment in unilateral orbital blowout fractures. This fracture type is usually caused by trauma and affects the bony floor or inner wall of one eye socket. Traditionally, functional impairments such as eye movement disorders and malposition of the globe have guided treatment decisions.

This group of researchers aimed to determine what computer-assisted measurements were associated with treatment choice. Disior™’s CMF Orbital was used to automatically segment computer tomography (CT) images of the patient's anatomy so that the extent of the orbital could be determined. This methodology was applied, retrospectively, to a cohort of 293 patients that were treated for unilateral orbital blowout fracture at the Trauma Unit of the Helsinki University Hospital during 2013-2018. Nearly one-third of these patients underwent surgery. 

Example of segmented, healthy orbits using Disior CMF Orbital

The key results of this study were:

• The orbital volume difference compared to contralateral uninjured side (p = 0.008), fracture area (p < .001), and median fracture depth (p <.001), were found to differ significantly between those surgically vs non-surgically treated.
• Patients with higher fracture depth were more likely to have undergone surgery (OR 1.40, p < 0.001), compared to those who were conservatively treated.
• Moderate or severe displacement of extraocular muscles (OR 6.15, p < .001, respectively OR 30.75, p < .001), were explanatory factors for surgery compared to mild or no extraocular muscle displacement. 

Example of surface meshes of orbital volume segmentation (blue) from CMF Orbital with automatically segmented fracture surface area (purple).

The authors found that in addition to traditional measures, orbital volume change, displacement of the extraocular muscles and radiological measures of fracture extent (obtained with CMF Orbital) were associated with surgical intervention. 

This study concluded that computer-aided methods (like Disior™ CMF Orbital) facilitate rapid and reliable anatomical segmentation, measurement of orbital fracture extent and 3D visualization of the orbital volume of large datasets (e.g. 293 patients analyzed in this study) of CT and CBCT images in clinical research. 

Congratulations to this international team of researchers on their innovative work!

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