Background: Various options of traumatic orbital floor defects were used over the past years which may be autologous as bone & cartilage graft or synthetic as titanium mesh and suprafoil mesh. The present work aimed to compare the outcomes of using autogenous conchal cartilage grafts and synthetic titanium mesh for better management of post-traumatic orbital floor defects reconstruction and to determine the most preferable materials for different sizes of the defect.

Methods: This was a non-randomized controlled trial where 18 patients were subdivided in 2 equal groups, (group I) for people treated with conchal cartilage graft where the defect was less than 2 cm2, and (group II) for people treated with titanium mesh where the defect was more than 2 cm2. For all patients several parameters were collected involving operation difficulties, radiological manifestations, operation time, early and late follow up, early and late surgical complications, pre and post-operative change in visual acuity and conchal cartilage graft donor site complications.

Results: Both groups showed satisfying results in reconstruction of orbital floor defect with higher operation time mean (2.8 ± 0.43 hrs. vs 2.44 ± 0.4 hrs.) and higher incidence of operation difficulties in group II (p=0.045).

Conclusion: Titanium mesh (for orbital floor defects larger than 2 cm2) and conchal cartilage graft (for the defects smaller than 2cm2) were excellent and highly successful in orbital floor defect reconstruction. There are still controversial opinions on which implant material should be used for reconstruction of the orbital floor.