Orbital Floor Reconstruction With Custom Made plates - A New Approach

operating room; or minor when only required medical treatment or minor surgery in office setting. Success was defined as maintenance of over 50% of the graft, bone continuity for continuity defects and absence of infection. Bone consolidation on radiographswas examined in 3 time intervals: Immediate post surgery (T1), two to three months after (T2), Last follow up (T3/LFU). Results: A total of 59 (37 males and 22 females) patients met criteria. 31 patients has continuity defects whereas 28 had non-continuity type. The age range was 13-60 years. Six patientswere edentulous. 49% of patients were reconstructed for ablative defects related to benign pathology, while others included trauma, malignancy and other conditions. In group 1, 23 patients had true lateral defects, whereas 8 had complete symphysis involvement. There was an overall 87% success rate in this group, with 95% success for true lateral defects (n=1 failed cases) and 100% success in the symphyseal group for defects less than 9cm. However, when all sizes were considered (including over 9cm defects), the mean success rate was 62% (n=3 failed cases). Group 2 had an 82.1% success rate with five failed cases. Major complications included seroma (n = 1) requiring surgical drainage, and infection (n=3) requiring return to debridement and/or graft removal. Minor complications included dehiscence of recipient (n=7) and donor (n=1) sites, persistent hip pain (n=3), transient paresthesia (n=15) and temporary cranial nerve VII injury (n=7). Conclusions: NVBGs are highly successful in mandibular continuity reconstruction for non-cancer patients and should be considered as first choice for defects less than 9 cm, irrespective of symphysis involvement. They may be less predictable for defects larger than 9cm but can be considered in these cases.