Address: Elske Strabbing Department of Oral and Maxillofacial Sur- gery Erasmus University Medical Center Dr. Molewaterplein 40 3015 GD Rotterdam The Netherlands

Computed tomography (CT) is commonly used for the diagnosis, treatment planning, and prognosis of pure orbital fractures of the orbital floor and medial wall. The aim of this study was to systematically review the current literature in order to establish an overview of CT parameters relevant to the choice of treatment and (long-term) clinical outcome for patients treated operatively and conservatively. The PRISMA guidelines were followed. Databases were searched using the terms ???orbital fracture??? and ???computed tomography???. Studies evaluating the relationship between CT parameters and the treatment decision or clinical outcome (enophthalmos, diplopia, and/or limitation of ocular movement) were included. The search yielded 4448 results of which 31 were included (except for three, all were retrospective). The systematic use of CT imaging in orbital fractures of the floor and the medial wall can be of great value in the treatment decision and prediction of (long-term) clinical outcomes for both conservatively and surgically treated patients. The following parameters were found to be the most relevant: fracture size, fracture location, orbital volume, soft tissue involvement, and craniocaudal dimension. Although some show great individual potential, it is likely that incorporating all parameters into an algorithm will provide the best predictive power and thus would be the most practically applicable tool.

Automated summary

This study systematically reviewed the literature to establish the relevant CT parameters for treatment choice and clinical outcome prediction in patients with pure orbital fractures. It found that fracture size, fracture location, orbital volume, soft tissue involvement, and craniocaudal dimension were the most relevant parameters. Incorporating all parameters into an algorithm would provide the best predictive power.