Diagnostic analysis of vertical orbital dystopia and canthal tilt for surgical correction

Lee, Juyoung; Choung, Han‐Wool; Choung, Pill‐Hoon

doi:10.5125/jkaoms.2020.46.6.379

Cited by 1 publication

(2 citation statements)

References 25 publications

(39 reference statements)

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“…3,[7][8][9] Clinical and intraoperative evaluation is crucial for differentiating between orbital and global dystopia and identifying the adequate therapeutic and surgical management. [10][11][12] True orbital dystopia is defined by malposition of the orbits relative to each other, whereas global dystopia is a result of malposition of the ocular globe relative to the skeletal framework of the bony orbit. 11 Correction of true VOD is a challenging facial reconstructive procedure requiring a transcranial approach for vertical translocation of one or both orbits to restore orbital symmetry.…”

Section: Special Topicmentioning

confidence: 99%

“…3,7–9 Clinical and intraoperative evaluation is crucial for differentiating between orbital and global dystopia and identifying the adequate therapeutic and surgical management. 10–12 True orbital dystopia is defined by malposition of the orbits relative to each other, whereas global dystopia is a result of malposition of the ocular globe relative to the skeletal framework of the bony orbit. 11…”

mentioning

confidence: 99%

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“A Simplified Approach for Surgical Correction of Vertical Orbital Dystopia: A 45-year Retrospective Cohort Study.”

Wolfe

Ainuz

Ragheb

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Vertical orbital dystopia (VOD) results in significant facial asymmetry, psychological distress, and poor quality of life in affected patients. The traditional approach (TA) for surgical correction has entailed a standard frontal craniotomy along with circumferential orbital osteotomy, vertical translocation of the orbit, and bone grafting to the lower maxilla. Caution has been expressed regarding its invasive transcranial nature. In this report, the authors describe the limited approach (LA) for simplified surgical correction of VOD, which obviates the need for a standard frontal craniotomy. Methods: A 45-year retrospective review was conducted of all patients who underwent surgical correction of VOD, as performed by a single surgeon. Demographic details, procedural characteristics, and complications were compared between patients who underwent correction by the TA and those who underwent correction by the LA. Complications were defined as cerebrospinal fluid leak, infection of the frontal bone, permanent diplopia, permanent ptosis, sudden-onset vision loss, persistent asymmetry, and surgical revision. Results: Forty patients met inclusion criteria for correction of true VOD, of which 18 underwent the TA and 22 underwent the LA. Mean length of hospital stay was 5.3 ± 2.3 days and 4.0 ± 1.5 days for the TA and LA cohorts, respectively. Mean follow-up time was 4.9 ± 7.5 years for the TA cohort and 2.6 ± 3.3 years for the LA cohort. The only reported complications were persistent asymmetry in 2 patients in the TA cohort, with 1 patient requiring surgical revision because of undercorrection, whereas the LA cohort exhibited no postoperative asymmetry or need for surgical revision. Conclusions: Both the TA and the LA are effective for surgical correction of VOD. The limited craniotomy of the LA reduces exposure of intracranial structures and adequately achieves postoperative symmetry.

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