Orbital floor reconstruction with autogenous mandibular symphyseal bone grafts

Abstract Purpose: This article shows the usefulness of the mandibular symphysis as a source of bone graft for the reconstruction of the orbital floor. Patients and Methods: A retrospective study was conducted on 16 patients who had isolated blowout fractures (n = 10) or orbital floor defects (n = 6) reconstructed with mandibular symphyseal bone grafts. Symphyseal bone grafts were used when the defects were less than 2 cm in diameter. Patients were examined at recall visits for any evidence of unsuccessful reconstruction by checking extraocular movements, and evidence of diplopia or enophthalmous. Results: During a mean follow-up of 12 months (range, 9 to 36 months), patients had no postoperative complaints. There were no instances of infection at the surgical sites, and none of the grafts were extruded or lost. There was good restoration of the orbital floor, with no clinical evidence of enophthalmous or diplopia. Extraocular movements were intact in all patients. Conclusion: The mandibular symphysis is a readily available source of autogenous bone that can be harvested with minimal morbidity. Its contour is suitable for use in orbital floor reconstruction. It merits consideration when autogenous bone grafts are considered for orbital floor defects less than 2 cm in diameter.