Abstract
Introduction: Movement of the bony orbits can be accomplished with box osteotomy (BO) or facial bipartition (FB). Both procedures have been shown to successfully reduce interdacryon distance as well as the overlying soft tissue, but little data exists to support the use of one procedure over the other. This study compares the outcomes of BO, FB, and facial bipartition with distraction or advancement (FBD) at a single center and proposes an algorithm to assist in preoperative decision-making. Methods: A retrospective review of patients undergoing BO, FB, or FBD was performed at our institution from 2009 to 2018. Patient demographics and surgical history were recorded. Length of hospital stay and complication rates were compared. Correction of interdacryon distance was measured on pre- and post-operative CT scans. Statistical significance was determined with Pearson’s chi-squared test or ANOVA (p<0.05). Results: 26 patients were included: 7 FB, 7 BO, and 12 FBD with varying diagnoses. In patients with hypertelorism,no significant difference was seen in preoperative interdacryon distance in FB (30.7±6.7mm), BO (31.6±4.3mm), and FBD (26.8±3.5mm, p=0.273). Postoperatively, no significant difference was seen in interdacryon distance between the groups (22.7±2.1 mm vs 22.9 ± 4.8 mm vs 21.8±2.9mm, p=0.215). Six patients (23%) - 3 FB patients (43%) and 3 FBD patients (25%) - experienced complications related to surgery. There was no mortality. Three patients (12%) required reoperation. There was no significant difference in length of hospital stay between the groups (FB 9.6±6.6, BO 5.9±2.5, FBD 9.2±3.2 days, p=0.200). Average follow up time was 1.3±2.3 years in FB, 3.7±3.2 years in BO, and 4.7±3.0 in FBD (p=0.294). Conclusion: Box Osteotomy and facial bipartition are effective operations for correcting orbital malposition. Both procedures are safe when performed by an experienced surgeon in a tertiary care facility. A surgeon must take into consideration other surgical needs to correct the facial cascade such as canthal tilt, malar prominence position, and palatal arch width when determining which procedure to perform.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
