Orbital wall reconstruction with bone grafts from the outer cortex of the mandible

• Published in: Journal of cranio-maxillo-facial surgery 2004-12, Vol.32 (6), p.374-380
• Main Authors: Kosaka, Masaaki, Matsuzawa, Yusuke, Mori, Hiromasa, Matsunaga, Kazuhide, Kamiishi, Hiroshi
• Format: Article
• Language: English
• Subjects: 3D-CT; Adolescent; Adult; Aged; Biological and medical sciences; Blowout fracture; Bone graft; Bone Transplantation - methods; Child; Cicatrix - prevention & control; Complication; Dentistry; Donor site; Female; Fracture Fixation; Humans; Imaging, Three-Dimensional; Male; Mandible - diagnostic imaging; Mandible - surgery; Medical sciences; Middle Aged; Orbit - surgery; Orbital Fractures - surgery; Osteotomy - methods; Otorhinolaryngology. Stomatology; Postoperative Complications - prevention & control; Retrospective Studies; Tissue and Organ Harvesting - methods; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2004.06.006

The purpose of the study was to assess the efficacy of bone grafting from the mandibular outer cortex for reconstructing the orbital walls. Bone grafting was performed in 75 patients. The site the transplants were harvested from were: A: mental region, B: area posterior to the mental foramen, C: ramus region. In order to obtain the appropriate curvature for the orbital floor, proper selection of the donor area is required. The bony defect size was confirmed pre-operatively from 3D-CT data. Bone, characteristically 2–3 mm thick, was harvested from each area and grafted into the blow-out fractures. Out of the 75 patients 13 cases underwent reconstruction using mandibular outer cortex bone from area A, 8 from area B, and 54 from area C. The maximum size available for harvest from area C was 7×4 cm; material from this area could also be used for the repair of both medial and inferior orbital wall defects if necessary. Bone harvest from the mandible affords several advantages including (1) ease of harvest, (2) ease of trimming, (3) appropriate size and curvature, (4) absence of functional disability, (5) no secondary deformity, (6) no visible scars, (7) post-operative immobilization not necessary, (8) absence of post-operative difficulties with respect to breathing and walking and (9) major complications are rare.