Introduction : Reconstruction of zygomatic-orbital complex remains as one of the challenging problems in the field of maxillofacial reconstruction regarding severe deficiencies as in syndromic Caesars, post traumatic deformities and deficiencies due to pathological conditions. The unique three dimensional anatomy of zygomatico-orbital complex lends it very difficult to get satisfactory results especially in severe deficiencies. The purpose of the current study is to provide and evaluate a simple technique for reconstruction using three dimensionally contoured calverial.

Materials and methods : Ten patients were included in the study, age range from 6 years to 40 years (three patients with Treacher’ Collin’s Syndrome, two patients with Goldenhar Syndrome, three patient post traumatic and two patients where the deficiencies were due to pathological conditions). Exposure for reconstruction provided by coronal incision without need for peri orbital incisions, the zygomatico-orbital complex was reconstructed using full thickness calverial bone grafts that have been recontoured three dimensionally and then inset and stabilized using plates and screws. Any remaining orbital defects were reconstructed. Lateral canthopexies were completed and secured to new orbital rim if needed.

Results : CT scans done before and immediately after surgeries as well clinical pictures revealed zygomatico-orbital morphological improvement that was achieved in all patients with follow up period ranging from 6 to 24 months at the close of the study.

Conclusions : We believe the reconstruction of zygomatico-orbital complex using three dimensionally contoured calverial bone graft provides simple but reliable method for management of severe deficiencies.