Correction of enophthalmos with rib bone segment and diced cartilage grafts

We introduce our experiences of correcting enophthalmos with a rib bone segment graft and diced cartilage graft simultaneously.The affected orbit was exposed through a subcilliary incision, a medial brow incision, and a lateral brow incision. The periorbita was carefully dissected from the bony orbit circumferentially. The affected area was examined, and the size and shape of the bone graft were determined. A 5-cm incision was made at the 7th rib-cartilage junction, and the 7th and 8th ribs and costal cartilage was harvested as needed. The donor site was closed. The harvested rib bone segment was molded with a bender to fit the defect, and the cartilage was diced into 2 × 2 × 2-mm cubes. The diced cartilage was inserted into the subperiosteal space, and fibrin glue was sprayed.Nine patients (3 male and 6 female subjects) were operated on, and the average follow-up period was 9 months. On the exophthalmometry, the preoperative difference was 4.6 ± 1.7 mm, and this improved to 1.4 ± 0.8 mm at 3 months postoperatively. The average improvement was 3.2 mm.It is thought that the correction of enophthalmos by the combined use of a rib bone segment and cartilage grafts is very effective because bone and cartilage have complimentary effects in maintaining the globe's position.