Treatment of orbital floor fracture with conchal cartilage

Penna, Waldemar Chaves Nascimento Brandão; Oliveira, Isabel Camilo de; Arízaga, David Santiago Ordonez; Ferreira, Marco Túlio Ribeiro Peixoto; Resende, Márcio Henrique Lima; Souza, Gustavo Moreira Costa de; Costa, Sirlene Maria da; Oliveira, Klaus Rodrigues de

doi:10.5935/2177-1235.2017rbcp0029

Cited by 3 publications

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“…These articles were filtered for relevance and duplication, resulting in 46 articles. A full-text assessment was then performed, which reduced the number of articles to 16 articles 13 , 14 , 23 – 36 . With regards to quality of evidence, all of the studies which were eligible for inclusion were considered to be of moderate quality.…”

Section: Resultsmentioning

confidence: 99%

“…However, Penna and colleagues stated that harvesting from the nasoseptal cartilage carried an increased risk in morbidity when compared to harvesting cartilage from the auricle or concha. Complications which may arise within the donor area included septal haematoma, septal perforation, and saddle nose deformity 23 , 25 . Although no donor site morbidity was noted within the studies which utilised nasoseptal cartilage, two studies within our review argued that conchal cartilage is superior to septal as it was easier to harvest, and due to its natural curve, it required less modelling 14 , 23 .…”

Section: Discussionmentioning

confidence: 99%

“…Complications which may arise within the donor area included septal haematoma, septal perforation, and saddle nose deformity 23 , 25 . Although no donor site morbidity was noted within the studies which utilised nasoseptal cartilage, two studies within our review argued that conchal cartilage is superior to septal as it was easier to harvest, and due to its natural curve, it required less modelling 14 , 23 . Chowdhury and Krause agreed that the natural curve of the conchal cartilage graft is advantageous for orbital floor repairs, as it is likely to fit easier when compared to cartilage grafts from other sites 45 .…”

Section: Discussionmentioning

confidence: 99%

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A systematic literature review and narrative synthesis on the use of autologous cartilage in the repair of orbital fractures

Abukhder,

Onions,

Flaherty

et al. 2024

Annals of Medicine &Amp; Surgery

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Introduction: Fractures of the orbit are common injuries within the maxillofacial skeleton, and can often result in restrictions to ocular movement, diplopia, and enophthalmous if herniation of globe content occurs. Various studies have demonstrated the use of autologous cartilage grafts in the reconstruction of orbital fractures. Methods: A systematic review protocol was registered with PROSPERO, and reported in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses. Comprehensive electronic search strategies of four databases were developed. Studies were screened according to the inclusion and exclusion criteria by two independent reviewers. Results: Seven thousand one hundred seventy-one articles were identified following a comprehensive literature search. These articles were filtered for relevance and duplication, which reduced the number of articles to 16. A total of 259 patients underwent orbital reconstruction with the use of autologous cartilage. Conchal cartilage was harvested in 148 patients, auricular cartilage in 22 patients, nasoseptal cartilage in 72 patients, and costal cartilage in 17 patients. Thirty, seven, twelve, and four complications were observed in patients where cartilage was harvested from the concha, auricle, nasoseptum and rib, respectively. Most common complications included diplopia (n=23), infra-orbital para/anaesthesia (n=27), and enophthalmos (n=7). No failure of graft or donor site morbidity were observed in the studies. Conclusion: Autogenous materials such as cartilage can be used as an alternative for orbital reconstruction. Cartilage was considered by the authors to provide adequate structural support to the orbital contents, and that it was easy to harvest, shape, and position.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A systematic literature review and narrative synthesis on the use of autologous cartilage in the repair of orbital fractures

Abukhder,

Onions,

Flaherty

et al. 2024

Annals of Medicine &Amp; Surgery

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“…The relationship between the eyeball, musculature, fat and orbit volume is considered as the main mechanism in the production of enophthalmos and diplopia; thus, the surgical repair seeks to reduce the herniated tissue, release possible entrapments of orbital fat and musculature, reposition the bone fragments and reconstruct the orbit floor, returning anatomic sustainability and avoiding relapses and esthetic damage to the patient 5. In the impossibility of successful treatment, there is a significant risk of the patient evolving with restriction of eye movement, diplopia, and dystopia, interfering not only with functionality but also with the esthetics of the orbital region 6,7…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Blow-out Fracture: A New Perspective

Lima

Soares

Catunda

et al. 2023

Journal of Craniofacial Surgery

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The present work aims to report 2 clinical cases of the use of current technologies for the treatment of orbital fractures. The cases are of patients who were victims of car accidents and who developed a blow-out orbital fracture. Clinically, they presented periorbital ecchymosis, blepharoedema, enophthalmos, and ophthalmoplegia and, therefore, underwent surgical reconstructive treatment. For both cases, preoperative computed tomography and biomodel impression of the orbits were performed. The modeling of the titanium mesh covering the defect in the biomodel that would be used in the surgery was performed. In the intraoperative period of reduction and fixation of the fracture with the titanium mesh, optics were used to better visualize the posterior defect, as well as computed tomography to ensure that the entire affected area was reconstructed. Both patients were followed up in the postoperative period and evolved without clinical and functional complaints.

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Assessment of the efficacy of auricular conchal cartilage graft in repairing orbital floor fractures and its effect on diplopia: a nonrandomized clinical trial

Deep,

Baroudi,

Assad

2023

Annals of Medicine &Amp; Surgery

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Background: Orbital fractures are a common sequela of maxillofacial zone trauma. Rapid assessment and management are essential for successful reconstruction. The selected treatment method depends on fracture types, accompanied injuries, and intervention time. Implantable grafts used to be from autologous materials. The study aimed to evaluate the effectiveness of using the auricular conchal cartilage taken from the ear to repair orbital floor fractures in cases of minimal bone loss, less than (2×2) cm. Material and Methods: A prospective single-arm, nonrandomised clinical trial was conducted during the past 4 years (from 2018 to 2022). A total of 15 cases, who had visited the department of oral and maxillofacial surgery department with orbital floor fractures, were enrolled. The participants underwent conchal cartilage grafting for orbital floor fracture reconstruction. The time factor to perform the surgery after trauma had been considered. Patients were closely monitored for the development of double vision (diplopia) at 15 days, 1 month, and 3 months postsurgery. Results: The results showed statistically significant differences during the follow-up period following the surgical procedure. They appeared to have complete restoration of eye movements, restoration of the normal positioning of the eyeball affected by the orbital floor fracture compared to the healthy eyeball, and regression of double vision (diplopia) throughout the follow-up period. Conclusion: Using the auricular conchal cartilage graft in repairing fractures of the orbital floor resulted in the improvement of the functional aspect of the eyeball and the restoration of the esthetic aspect.

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Treatment of orbital floor fracture with conchal cartilage

Cited by 3 publications

References 0 publications

A systematic literature review and narrative synthesis on the use of autologous cartilage in the repair of orbital fractures

A systematic literature review and narrative synthesis on the use of autologous cartilage in the repair of orbital fractures

Surgical Treatment of Blow-out Fracture: A New Perspective

Assessment of the efficacy of auricular conchal cartilage graft in repairing orbital floor fractures and its effect on diplopia: a nonrandomized clinical trial

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