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This review from the Netherlands attempts to evaluate the relationship between CT parameters and the treatment that is used in clinical outcome (enophthalmos, diplopia and/or limitation in ocular movement). The authors look at fracture size, fracture location and involvement of anatomical structures, the soft tissue changes and orbital volumes. Whilst some papers advocate for and against surgical treatment, there is no individual CT parameter with sufficient predictive power to predict the clinical outcome. The authors acknowledge the limitations of the study including the use of Hertel exophthalmometer which is an instrument that is thought to have a potentially large measurement error. Nonetheless, it is a reasonable discussion of the pros and cons of each parameter when one considers assessing the merits of treatment as well as consent.

CT parameters in pure orbital wall factures and their relevance in the choice of treatment and patient outcome; a systemic review.
Wevers M, Strabbing EM, Engin O, et al.
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Stuart Clark

Manchester Royal Infirmary, Manchester, UK.

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