Treatment of orbital floor blowout fractures with conchal auricular cartilage graft: A report on 14 cases

Purpose: We sought to present follow-up on 14 cases in which conchal cartilage graft was used to span small orbital floor defects (up to 2 X 2 cm). Materials and Methods: Fourteen patients with orbital floor blowout fractures were included in the study; in 8 cases, there was associated fracture of the inferior orbital rim. The decision to proceed surgically was based on the presence of at least one of the following conditions: diplopia, enophthalmos, herniation of orbital tissues through gaps in the orbital floor bone, and concomitant displacement of bone fragments of the inferior orbital rim. Auricular cartilage was used in all cases. Access to the orbital floor was via subtarsal incision unless a laceration was present and useable. Results: The incidence of clinical signs during follow-up and the surgical complications found (I case of entropion, I case of palpebral edema) are fully comparable with those reported in the literature; they do not appear to be correlated to the use of a cartilage graft. Conclusions: The use of auricular cartilage has wide application for small orbital floor defects. The conchal graft is easy to harvest. It provides an optimal support function for the globe with minimum donor-site morbidity. A graft of adequate size ensures adequate stability. (C) 2002 American Association of Oral and Maxillofacial Surgeons.