Abstract
Introduction: The clinical manifestation of orbital hypertelorism includes congenitally increased interorbital distance (the distance between bilateral lacrimale). Greg applied this term firstly in 1924. Orbital hypertelorism may be present in a variety of craniofacial deformities, such as craniofacial cleft, Apert syndrome, Crouzon syndrome and so on. However, orbital hypertelorism secondary to non-syndromic craniosynostosis is relatively rare. From 2013 to 2016, we performed modified surgery through intra-and-extra-cranial approach in three patients with congenital craniosynostosis associated with orbital hypertelorism and got satisfactory results. To report three patients who was diagnosed as orbital hypertelorism secondary to craniosynostoses treated by using inverted U-shaped osteotomy combined floating frontal flap procedure through intra-and-extra-cranial approach. Methods: Three patients diagnosed as orbital hypertelorism secondary to craniosynostosis, underwent floating frontal flap procedure combined with inverted U-shaped osteotomy by intra-and-extra-cranial approach. Inverted U-shaped orbit frame was formed and moved inward to attach the central bone bridge, with the fixation of titanium mesh and screw. Medial canthal ligament was cross fixed to contralateral orbit frame and thus the skin on inner canthus could fit bone surface tightly. With inverted U-shaped orbit frame fixed with each other, a structure of fronto-orbital bone bridge was formed. After that we made a center vertical osteotomy of the floating frontal flap and rotated both of the frontal flaps inward by 90 degrees. Appropriate shape of supraorbital area and proper volume of anterior skull were successfully achieved with the frontal flaps fixed to the fronto-orbital bone bridge. Results: These patients got satisfactory results, with the orbital distance being corrected to the normal range, meanwhile the premature fused coronary suture was released. The forehead and orbits region obtained normal appearance. Conclusion: The satisfactory result show that floating frontal flap combined with inverted U-shaped osteotomy procedure by intra-and-extra-cranial approach is one kind of safe and effective way to correct orbital hypertelorism secondary to craniosynostoses.
Published Version
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