Comparison of conchal cartilage graft with nasal septal cartilage graft for reconstruction of orbital floor blowout fractures

Abstract

Our aim was to compare autogenous nasal septal cartilage and conchal cartilage as grafts for reconstruction of orbital blowout fractures. Twenty-two patients with blowout fractures were randomly assigned to two groups for treatment with a graft of nasal septal cartilage or conchal cartilage. Patients were evaluated for the presence of enophthalmos, diplopia, dysfunction of the infraorbital nerve, and restriction of the ocular muscles. Patients with enophthalmos of more than 2 mm were included in the study, and were followed up postoperatively at 10 days, 1 month, and 3–6 months. The patients treated with a nasal septal cartilage graft had significantly better correction of enophthalmos than those treated with conchal cartilage ( p = 0.02) after 10 days ( p = 0.02), 1 month ( p = 0.004), and 3–6 months ( p = 0.001). There was significantly less residual enophthalmos in the nasal septal graft group after 1 month (0.91 compared with 1.72 mm, p = 0.02), and after 3–6 months (1.0 compared with 2.54 mm, p = 0.008). Correction of enophthalmos was considerably better in patients who were operated on within 4 weeks of injury. We think that nasal septal cartilage is a better graft than conchal cartilage for reconstruction of blowout fractures. The time to intervention (the earlier the better) is a critical point in the correction of enophthalmos.