Use of membrane and bone grafts in the reconstruction of orbital fractures

Abstract

Objective: To present and analyze the clinical results derived from the use of different grafts for the reconstruction of orbital defects during a 10-year period.

Study design: Fifty-five fracture cases with orbital bony defect, requiring a graft, are presented. The surgical treatment includes the reconstruction of the fracture (osteosynthesis) and the repair of the remaining bone defect by graft, with the type of graft dependent on the size of the defect. For minor defects membranes were used (lyophilized dura or alloplastic dura mater), whereas major defects were repaired with bone grafts (autografts, heterografts, or bone substitute material). All patients have been regularly evaluated for at least one year postoperatively.

Results: All grafts were well tolerated by the patients. Diplopia subsided in all but 5 cases, motility disturbance was fully repaired in all but 3 cases. Esthetics were improved in cases with severe bone defect.

Conclusion: The wide variety of grafts available allows successful reconstruction of all types of orbital bony defects. The clinician should be able to use different types of grafts depending on the type and size of the defect.