Reconstruction of Orbital Floor With Auricular Concha

Abstract

Orbital floor fractures of varying sizes commonly occur after orbital injuries and remain a serious challenge. Serious complications of such fractures include enopthalmos, restriction of extraocular movement, and diplopia. There is a dearth of literature that can be applied widely, easily, and successfully in all such situations, and therefore there is no consensus on the treatment protocol of this pathology yet. Autogenous grafts and alloplastic and allogenic materials with a wide variety of advantages and disadvantages have been discussed. The value of preoperative and postoperative ophthalmological examination should be standard of care in all orbital fracture patients. An ideal reconstructed orbital floor fracture should accelerate the restoration of orbital function with acceptable cosmetic results. Management parameters of orbital fractures such as timing of surgery, incision type, and implant materials, though widely discussed, remain controversial. In this study, 55 patients with orbital floor fractures surgically reconstructed with conchal cartilage grafts between 2008 and 2014 were retrospectively evaluated. Complications and long-time follow-up visit results have been reported with clinical and radiographic findings. The aim of this study was to present the authors' clinical experiences of reconstruction of blow-out fractures with auricular conchal graft and to evaluate the other materials available for use.

Clinical Outcome Following Surgical Repair of Small Versus Large Orbital Floor Fractures Using Polyglactin 910/Polydioxanone (Ethisorb®)

“…Although undeniable progress in the management of orbital floor fractures has occurred over the past decades, there is still a lack of broad consensus as to which material(s) should be used to restore proper anatomy of the orbital floor in order to achieve best clinical results. This is also reflected by the still very high number of recent studies describing various approaches and materials to reconstruct the orbital floor, such as titanium meshes [27], partially absorbable meshes [28], bioresorbable implants [29,30], resorbable collagen membranes [31], polydioxanone foils [32], porous polyethylene sheets [33], bioactive glass S53P4 implants [34], auricular conchal grafts [35], rib bone grafts [36], or heterologous cortical bone [37].…”

The Conchal Vascular Foramen of the Posterior Auricular Artery: Application to Conchal Cartilage Grafting

“…From a surgical perspective, conchal cartilage grafting has been used to repair traumatic orbital wall defects [9,10], partial helical defects [11], and nasal septum reconstruction [12]. Lan et al [13] reported that in 372 patients who underwent conchal cartilage harvesting for rhinoplasty, 1.1% (four cases) developed keloids and 1.3% (five cases) incurred hematomas.…”

Advances and Prospects in Materials for Craniofacial Bone Reconstruction

“…Apart from autologous bone tissue, cartilage (i.e., auricular concha, nasal septum), periosteum, and tensor fascia lata are also employed in craniofacial bone repair. − Autotransplantation also has a few drawbacks, including donor site morbidity, unpredictable resorption, and prolonged surgery procedure. , …”