Introduction: Reconstruction of orbital wall defects perturb surgeons not only for
cosmetic problems but also for facing the risqs of clinically
significant functional ophthalmic disturbances as enophthalmos or
dystopia. Traumas,infections,tumoral invasions and/or iatrogenic
extensive bone resections are known main causes of orbital wall
defects
Methods: 2 fixed head cadavers on four sides were used in order to define
incision technique, the anatomy of zygomatic arc(ZA) and
neigbourhood in BAU, Rhoton's Anatomy Lab,Istanbul.Mayfield
head-holders were used for positioning.Titanium miniplate and
mini screws systems utilized for attachement of ZA autogrefts in
replacement orbital wall defects in unison.
Results: Optimal positioning principles for best exposure of anatomical
landmarks has been defined.The modification of Al-Mefty’s
cranioorbitozygomatic approach incision with Gillie’s was
performed in order to dissect zygomatic arc(ZA)(Figure-1). The
anatomy of ZA is defined with measures(Figure-2, Figure-3).
Successful well-matched replacement of ZA autogreft attached
with mini-plate/screw sytems has shown as lateral and/or superior
orbital walls in Figure-3.
Conclusions: Modifications of different incison techniques may result better
exposure. Detailed anatomical definitions of selected anatomical
regions and neighbourhood is essential in order to avoid
complications. Zygomatic arc transposition may be a feasible,
economical technique with other known advantages of autogrefts,
and also very handy in emergency cases.
Patient Care: Known advantages of autogenous grefts are expected to have
better results in orbital reconstruction.
Learning Objectives: To obtain a cosmetic and estehetic results after surgery of orbital
pathologies. Safe, economic and less risqué material as an
autogreft and other known advantages of autogreft