Age at Surgery Significantly Impacts the Amount of Orbital Relapse following Hypertelorbitism Correction: A 30-Year Longitudinal Study

Abstract

Surgical correction of hypertelorbitism in patients younger than 8 years leads to a significantly higher rate of bony interorbital distance relapse compared with patients who undergo surgery at an older age. Neither the initial degree of severity nor the type of surgical technique correlates with relapse. The authors therefore recommend that in the absence of urgent factors necessitating early intervention, hypertelorbitism correction should be performed after 8 years of age.

Abordagem cirúrgica do hiperteleorbitismo na displasia craniofrontonasal

“…We fixed the inferomedial portions of the hemifaces to each other with plates and screws. We placed Autologous bone grafts form the skull cap on the lateral portions of the orbital edges and on the zygomatic arches that were medialized and eventually advanced 19 .…”

“…In the recent and late preoperative and postoperative periods, we performed bone measurements on frontal cephalograms 12,18,19 .…”

“…We then fixed the nasophrontal processes of the maxilla with steel wires, and the vertical pillars, with titanium plates and screws. Before closure, we raised a pericranial flap and advanced it till the base of the skull on the midline 19 .…”

“…In the intraoperative period, we measured the IOD with a pachymeter, before and after the inverted "V" osteotomy 12,18,19 . We classified all patients according to the IOD measured intraoperatively 6 : first degree (mild), IOD > 30 mm and ≤ 34mm; Second degree (moderate), IOD>34mm and ≤40mm; and third degree (severe), IOD>40mm.…”

“…Although its genetics and phenotypes have been addressed in numerous studies [8][9][10][11] , guidelines on the specific treatment of hyperteleorbitism are scarce and have been reported almost exclusively in the international context [12][13][14][15][16][17] . In previous works, our group 18,19 studied the recurrence of the orbital position after the correction of hyperteleorbitism in different craniofacial deformities. However, to the best of our knowledge, there are no national studies on the intracranial and extracranial surgical approach for the treatment of hyperteleorbitism specifically in patients with craniofrontonasal dysplasia.…”