Background

Computed tomography (CT) is currently the standard in postoperative evaluation of orbital wall fracture reconstruction, but cone beam computed tomography (CBCT) offers potential advantages including reduced radiation dose and cost.

Objectives

The purpose of this study is to examine objectively the image quality of CBCT in the postoperative evaluation of orbital fracture reconstruction, its radiation dose, and cost compared with conventional CT.

Methods

10 patients with orbital wall fractures in whom surgery was indicated underwent orbital reconstruction with radio-opaque grafts (bone, titanium-reinforced polyethylene, and titanium plate) and were assessed postoperatively with orbital CBCT. CBCT was evaluated for its ability to provide objective information regarding the adequacy of orbital reconstruction, radiation dose, and cost.

Principal findings

In all patients, CBCT was feasible and provided hard tissue image quality comparable to CT with significantly reduced radiation dose and cost. However, it has poorer soft tissue resolution, which limits its ability to identify the extra-ocular muscles, their relationship to the reconstructive graft, and potential muscle entrapment.

Conclusion

CBCT is a viable alternative to CT in the routine post- operative evaluation of orbital fracture reconstruction. However, in the patient who develops gaze restriction postoperatively, conventional CT is preferred over CBCT for its superior soft tissue resolution to exclude extra-ocular muscle entrapment.