Recent improvements in orbital reconstruction

The three-dimensional complexity of the orbit represents a challenge to even the most accomplished reconstructive surgeon. Reconstruction of the orbit after trauma or tumor extirpation requires an appreciation for both the functional and aesthetic attributes of the orbit. Failure to consider these issues can result in a limitation of extraocular movements, chronic epiphora, and migration of the globe. Orbital defects can be classified in to partial defects, those defects that involve one or more orbital walls, and extensive defects, those defects that involve the orbital rim, zygomatic body, or an orbital exenteration. Partial defects can be reconstructed with a variety of methods (ie, alloplasts, autografts, and so forth), whereas extensive defects commonly require more advanced techniques (ie, free-tissue transfer), to reestablish midface form and reconstitute an orbit suitable for prosthetic restoration. The following is a review of the current techniques for the reconstruction of partial and extensive orbital defects.