Reconstruction of the Floor of the Orbit by Bone Grafts

THE ORBITAL contour may be distorted by comminution of bone and telescoping of fragments in maxillary and zygomatic fractures, congenital malformations, loss of bone from osteomyelitis, radiation necrosis and destructive surgical procedures necessary in the eradication of malignant disease. Such distortion or disorganization points to the need for a suitable technic for restoration of the orbital floor and replacement of missing bone. In the case of comminution of bone along the infraorbital rim and in the orbital floor the fragments may sink into the maxillary sinus. Contraction occurs during the healing of the torn mucosa of the maxillary sinus, and the scar tissue formed tends further to draw the comminuted fragments downward. When fracture of the zygomatic bone results in separation of the frontozygomatic junction, ptosis of the eyeball is particularly evident (fig. la). The lateral palpebral ligament and the thick portion of Tenon's capsule, known as the suspensory