METHOD OF DETERMINING TACTICS FOR TREATING PATIENTS WITH AN ORBIT INFERIOR WALL DEFECT Russian patent published in 2018 - IPC A61B6/03 A61F9/07 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, radiology, ophthalmology, plastic and maxillofacial surgery, can be used for evaluation and classification of defects of the orbit inferior wall in order to determine the tactics of patient treatment and correct preoperative implant selection within the reconstruction of the orbit inferior wall. Diagnostic parameters are determined: type of the orbit inferior wall defect, location of the defect in relation to the orbit wall, anatomical characteristics of the skull and orbit, ratio of post-traumatic defect area to entire area of the orbit inferior wall (%). Type of the defect is determined based on a value of the volume and area of the orbit inferior wall defect and when values of the orbit inferior wall defect area up to 54 mm² inclusive and the orbit inferior wall defect volume up to 105 mm³ are combined, type of the orbit inferior wall defect is defined as low. When values of the orbit inferior wall defect area from 54 mm² to 117.2 mm² and the orbit inferior wall defect volume from 105 mm³ to 201.4 mm³ are combined, type of the defect is defined as average. When values of the orbit inferior wall defect area of 117.3 mm² and more and the orbit inferior wall defect volume of 201.5 mm³ and more are combined, type of the defect is defined as high or total. As anatomical characteristics of the skull and orbit, a facial skull shape, skull type, craniometric parameters of the orbit – width and height of the orbit are determined. Conservative treatment with dynamic observation is indicated in the presence of indicators: low type of the orbit inferior wall defect, localization of the defect – anterior or lateral parts of the orbit inferior wall, eyriproposal shape of the facial skull, brachicranal type of the skull, orbit width with respect to orbit height of more than 95 %, ratio of the post-traumatic defect area to entire orbit inferior wall area of less than 6.65 %. Surgical treatment with the implant selection in accordance with the calculated volume and area of the defect is indicated in the presence of indicators: average type of the orbit inferior wall defect, localization of the defect – posterior or medial parts of the orbit inferior wall, mesoprozopic or leptoprozopic shape of the facial skull, mesocranium or dolichocranium type of the skull, orbit width with respect to orbit height of less than 95 %, ratio of post-traumatic defect area to entire orbit inferior wall area of more than 6.7 %. Prosthetics of the orbit inferior wall in accordance with the size of the defect with the addition of elements of metalloesteosynthesis in the area of structures of the midface is indicated in the presence of indicators: high or total type of the orbit inferior wall defect, localization of the defect – posterior or medial parts of the orbit inferior wall, mesoprozopic or leptoprozopic shape of the facial skull, mesocranium or dolichocranium type of the skull, orbit width with respect to orbit height of less than 95 %, ratio of the post-traumatic defect area to entire orbit inferior wall area of more than 6.7 %.

EFFECT: method ensures the accuracy of the evaluation of the orbit inferior wall defect within the preoperative planning and postoperative control.

1 cl, 8 dwg, 2 ex, 2 tbl