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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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