Repair of traumatic inferior orbital wall defects with nasoseptal cartilage.

PURPOSE This study evaluated the effectiveness of nasoseptal cartilage for repairing traumatic orbital floor defects. PATIENTS AND METHODS Autogenous septal cartilage was used in 20 patients. They were evaluated for the presence or absence of diplopia, enophthalmus, infraorbital nerve paresthesia, and ocular motility disorders. Surgical indications for orbital exploration included entrapment of orbital tissues, large orbital defect (greater than 50% of the orbital floor or more than 8 mm), or orbital floor defects with involvement of other zygomaticofrontal complex fractures. RESULTS All patients were successfully treated by restoration of the orbital wall continuity. Follow-up at 1 week to 6 months showed 1 patient with postoperative enophthalmos and 1 patient with lower lid edema. There were no donor site and graft infections or graft extrusion. CONCLUSIONS Nasal septal cartilage is a readily accessible autogenous tissue that should be considered when an autogenous graft is needed for orbital floor defect reconstruction.

[1]  John W. Policy,et al.  The use of Teflon in orbital floor reconstruction following blunt facial trauma: a 20-year experience. , 1987 .

[2]  P. Weeks,et al.  A comparison of conjunctival and subciliary incisions for orbital fractures. , 1977, British journal of plastic surgery.

[3]  J. Wiesenbaugh,et al.  Orbital floor repair with nasal septal cartilage. , 1973, Transactions of the International Conference on Oral Surgery.

[4]  J R Bevivino,et al.  Reconstruction of Traumatic Orbital Floor Defects Using Irradiated Cartilage Homografts , 1994, Annals of plastic surgery.

[5]  P. Sullivan,et al.  Advances in the management of orbital fractures. , 1992, Clinics in plastic surgery.

[6]  P. Rubin,et al.  Orbital reconstruction using porous polyethylene sheets. , 1994, Ophthalmology.

[7]  J. Hes,et al.  Use of blocks of hydroxylapatite for secondary reconstruction of the orbital floor , 1990 .

[8]  R. Gliklich,et al.  Repair of Orbital Blow‐out Fractures With Nasoseptal Cartilage , 1998, The Laryngoscope.

[9]  M. Nagase,et al.  Evaluation of a bone substitute prepared from alpha-tricalcium phosphate and an acid polysaccharide solution. , 1991, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[10]  J Raveh,et al.  Early surgical intervention for orbital floor fractures: a clinical evaluation of lyophilized dura and cartilage reconstruction. , 1992, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[11]  P. Waite,et al.  The transconjunctival approach for treating orbital trauma. , 1991, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[12]  A. Pennings,et al.  Poly(L-lactide) implants in repair of defects of the orbital floor: an animal study. , 1990, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[13]  K Webster,et al.  Orbital floor repair with lyophilized porcine dermis. , 1988, Oral surgery, oral medicine, and oral pathology.