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Orbital Hypertelorism
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Preop Photos
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Preop
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Preop
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Preop Photos
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Preop Photos
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Hypertelorism
• MCD Bony = 36.6 mm
• MCD Soft Tissue = 42 mm
•
IPD = 58 mm• LCD = 90 mm
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Posterior Cranial Defect
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Bandeau and Paramedian Nasal
Osteotomies
Bandeau is at minimum 10 mm wide with a minimum of 6 mm between
the inferior bandeau cut and superior orbital rim.
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Lateral Extent of Box Osteotomies
Lateral Osteotomy is carried from inferior orbital fissure to inferior
bandeau
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Inferior Extent of Box Osteotomies
Inferior Osteotomy is made just inferior to infraorbital nerves and continued to the
pirirform –
position of unerupted teeth is noted on preop CT Scan
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Superior Intraorbital Osteotomy
Osteotomy is made ideally 2 cm posterior from orbital rim – medially
must be anterior to Crista Galli. It is ok to move slightly anterior duringthe medial osteotomy.
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Medial and Inferior Intraorbital Osteotomy
Osteotomy is continued from superior intraorbital osteotomy – posterior
to lacrimal apparatus – down and around the orbit until at the inferior
orbital fissure –
use small osteotome
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Preop/Postop 3D Reconstruction
Preop Postop
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Preop/Postop 3D Reconstruction
Preop Postop
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Preop/Postop 3D Reconstruction
Preop Postop
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Preop/Postop 3D Reconstruction
Preop Postop
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Preop/Postop 3D Reconstruction
Preop Postop
36.6 mm 16.1 mm
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Hypertelorism
• Medial Canthal Distance
reduced by 21 mm
• Goal is to reduce distance
to 14-18 mm
• Overcorrection by 3-4 mm
is appropriate when
concerned about relapse
16.1 mm
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Preop/Postop 3D Reconstruction
Preop Postop
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