Reconstruction of the orbital floor with periosteal autograft

Background: Various implants (silicon, teflon, titanium, polydioxanone, etc.) and transplants (dura, nasal septum, wall of the maxillary sinus) are used to stabilize the fractured orbital floor. Some of these methods have disadvantages with respect to hygiene, infection, or rejection. Method: In four patients, the fractured orbital floor was stabilized with autologous periosteum from the mastoidal region. Results: This graft is easy to obtain; the procedure is sterile, gives good cosmetic results, and is cost effective. Conclusions: Autografts are regarded as the material of choice in reconstructive surgery. For the reconstruction of the orbital floor, we suggest the use of a free periosteal flap from the mastoidal region. The risk of infection by virus or prion is excluded, rejection is unlikely, and the method is cost effective.