title: Sliced Costochondral Chip Grafts in Posttraumatic Enophthalmos Correction.
abstract: BACKGROUND
  Posttraumatic enophthalmos is a relatively common problem following orbitozygomatic fractures. However, inadequate long-term results are frequently observed due to the difficulty of performing intraoperative fine adjustments to soft-tissue volume and orbital size and gradual absorption of some grafted materials. Here, the authors describe an efficient method of enophthalmos correction using sliced costochondral bone and cartilage combination grafts.
  
  
  METHODS
  From 2005 to 2011, the authors corrected enophthalmos in 12 patients using sliced costochondral grafts. The mean follow-up period was 13 months. For costochondral graft harvest, an approximately 5-cm skin incision was made directly above the seventh costal cartilage, the perichondrium was peeled back, and a small piece of rib bone and costal cartilage was harvested from the anterior part of the seventh rib bone and cartilage and cut into 2-mm-thick slices. A subciliary and/or transcaruncular incision was made in the affected side eyelid to expose the operating field, subperiosteal dissection was performed in the orbit and orbital floor. The cartilage chips were gradually grafted onto the dissected areas from the posterior orbit.
  
  
  RESULTS
  Aesthetically satisfactory results were obtained in all patients. No complications in the donor area were observed. Furthermore, no patients experienced a recurrence or deterioration of diplopia over the follow-up period. One patient experienced temporary high intraocular pressure, which spontaneously resolved with medication and eye drops.
  
  
  CONCLUSIONS
  The costochondral graft is adequate for the reconstruction of the fracture, easy to obtain, easily adaptable to the orbital walls, and has minimal morbidity at the donor site.
authors.affiliation: *Department of Plastic and Reconstructive Surgery, College of Medicine of Seoul National University Hospital, Seoul †Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
authors.forename: Ie-Hyon
authors.initials: IH
authors.lastname: Park
authors.forename: Sa-Hyeok
authors.initials: SH
authors.lastname: Hong
authors.forename: Seok-Chan
authors.initials: SC
authors.lastname: Eun
mesh_terms: D000328:Adult; D066186:Costal Cartilage / Q000637:transplantation*; D015841:Enophthalmos / Q000209:etiology / Q000601:surgery; D005143:Eyelids / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D009915:Orbit / Q000293:injuries / Q000473:pathology / Q000601:surgery; D009917:Orbital Fractures / Q000150:complications*; D017060:Patient Satisfaction; D012272:Ribs / Q000637:transplantation; D013518:Surgery, Plastic / Q000379:methods