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Abstract The present study was conducted to evaluate the feasibility of usage of the free conchal cartilage graft clinically and radiologically in reconstruction of orbital floor fracture and if this graft is a good autogenous alternative option in orbital floor reconstruction or not. Ten adult patients with unilateral orbital floor fracture either isolated or associated with other maxillofacial fractures were selected for this study with the presence of one or more than one of the orbital trauma complications such as diplopia, enophthalmos, limitation of eye movements, ocular dystopia and infraorbital nerve paresthesia. With absence of major visual problems which may obstacle the evaluation criteria. After patient admission or referral from the emergency theatre, complete clinical examination, laboratory and radiological examinations were done .ophthalmology consultation was done to state upon the visual acuity of both eyes and for the other medico-legal issues. Clinical examination was done also for other maxillofacial injuries if present. Preoperative clinical photographs and radiological images were collected with documentation of any posttraumatic complications were present. All patients were subjected to surgical intervention within the period of two weeks after trauma using the infraorbital approach and reconstruction of the orbital floor was using the free conchal cartilage graft, Forced Duction Test was done intraoperative before and after orbital floor reconstruction to assess the good reduction of the herniated orbital content and to make asure that there is no any muscle entrapment after graft insertion. Postoperative evaluation was based on both clinical and radiological assessments:Clinical assessment for the improvement of the ocular mobility, diplopia enophthalmos and infraorbital parathesthia. Radiological assessment using postoperative CT to evaluate restoration of the orbital floor continuity, orbital volume and absence of soft tissue herniation into the maxillary sinus. The follow-up protocol was as follow: One week postoperatively, Then, weekly at the first month and, Monthly for 3 months. Clinical outcomes after completion the follow-up period were improvement of all the preoperative positive symptoms except persistence of infraorbital paresthesia in five patients no major postoperative complications were noted neither in the infraorbital region nor the donor site. Concerning the donor site two complications were noted, wound dehiscence in one patient and mild seroma in another one. The donor site morbidity was minimal, and no functional or aesthetic problems were found. Radiological outcomes showed two disadvantages of using the conchal cartilage graft, the first one was that the cartilage graft is not clearly seen as the other metallic implant or bony grafts and the second one is the image of fractured floor on the last postoperative CT scan was similar to that seen on the CT scan before operation. Magnetic resonance imaging examination was done for patient and showed good soft tissue reduction and accepted globe position |