Post-ablative reconstructon of the medial canthus and medial orbital wall using conchal cartilage graft with three illustrative cases

When the medial. third of the upper or lower eyelid has to be reconstructed after full-thickness tumour excision, we usually use Hubner tarsomarginal. grafts, but when medial, canthal lesions spread to the medial orbital wait without invading the orbital margin, conchal graft becomes our first surgical option. Previously reported solutions to this difficult problem are few and concern more directly medial orbital watt fractures. We found no article dealing specifically with the use of conchal. graft in post-ablative reconstruction of the medial. orbital watt. Nevertheless the concha presents great advantages over bone grafting or rib cartilage, because it is more flexible and malleable. And it is less prone to extrusion or infection as may be allografts implants. It is a very effective way to repair medial, orbital defects, but graft reorientation must be perfect to match exactly the medial orbital wall concavity. (c) 2005 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved.