J Korean Assoc Oral Maxillofac Surg.  2017 Dec;43(Suppl 1):S19-S24. 10.5125/jkaoms.2017.43.S1.S19.

Surgical correction of grade III hypertelorism

• Haq EU
• Qayyum MU
• Ilahı MI
• Janjua SA
• Aslam A
• Zahra R

• KMID: 2399921
• DOI: http://doi.org/10.5125/jkaoms.2017.43.S1.S19

Abstract

Orbital hypertelorism is an increased distance between the bony orbits and can be caused by frontonasal malformations, craniofacial clefts, frontoethmoidal encephaloceles, glial tumors or dermoid cysts of the root of the nose, and various syndromic or chromosomal disorders. We report a series of 7 cases of hypertelorism that were treated in our hospital. The underlying causes in our series were craniofacial clefts 0 to 14 (4 cases), craniofacial clefts 1 to 12 (1 case), and frontonasal encephalocele (2 cases), all congenital. Surgical techniques used to correct the deformity were box osteotomy and medial wall osteotomy with or without calvarial and rib grafts. A few of our cases were reoperations with specific challenges.

Keyword

Orbital hypertelorism; Box osteotomy; U-shaped osteotomy; Encephalocele

MeSH Terms

Chromosome Disorders
Congenital Abnormalities
Dermoid Cyst
Encephalocele
Hypertelorism*
Nose
Orbit
Osteotomy
Ribs
Transplants

Figure

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  Fig. 1 Clinical photograph of a 9-year-old girl of grade III hypertelorism with a history of previous neurosurgical procedure (craniotomy incision can be seen.).

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  Fig. 2 Preoperative three-dimensional reconstruction of the same patient showing frontal bone defect and grade III hypertelorism.

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  Fig. 3 Peroperative picture of correction of hypertelorism and forehead remodeling with autologous cranial bone. Fixation was done with stainless steel wire and osteosynthesis.

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  Fig. 4 Frontal view of the patient postoperatively.

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  Fig. 5 Lateral view of patient postoperatively.

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  Fig. 6 Postoperative (3 years) three-dimensional reconstruction showing good bone healing.

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