Surgical treatment of orbital hypertelorism: Historical evolution and development prospects

Publication date: Available online 13 July 2019Source: Journal of Cranio-Maxillofacial SurgeryAuthor(s): Claire Batut, Aline Joly, Nadine Travers, Benjamin Guichard, Arnaud Paré, Boris LaureAbstractOrbital hypertelorism (OR.H) is defined as an abnormal increase in the distance between the two orbits secondary to a skeletal anomaly, and it occurs in association with numerous congenital craniofacial malformations. Since its description by Greig in 1924, OR.H and the associated corrective procedures have captivated many surgeons. Here we present a discussion of the historical evolution of surgery for OR.H and highlight its future prospects. In the mid-twentieth century, only cover-up techniques simulating approximation of the eyes via an optical illusion were used, such as frontonasal skin resection, epicanthal fold surgery, and rhinoplasty. Subsequently, numerous surgeons attempted to correct the deformation using orbitonasal osteotomies via an extracranial approach. However, the outcomes were largely inadequate. Finally, in 1967, Tessier developed an efficient two-stage technique for OR.H correction via an intracranial approach; this technique revolutionized the management of OR.H. In 1970, Converse refined Tessier's procedure by performing a one-stage surgery that preserved olfaction. In 1976, Van Der Meulen developed the facial bipartition technique, which simultaneously corrected maxillary and craniofacial deformities. Box osteotomies and facial bipartition are still...
Source: Journal of Cranio Maxillofacial Surgery - Category: ENT & OMF Source Type: research

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Abstract OBJECTIVE: To assess the timing, type, and associated adjunct procedures for secondary cleft rhinoplasty nationally. DESIGN: Data were extracted from a national database of all secondary cleft rhinoplasty procedures (Current Procedural Terminology [CPT] codes 30460 and 30462). Frequency statistics were utilized to analyze demographics, comorbidities, surgical procedures, and timing. Chi-squared analysis and Fisher exact test were used for analysis. SETTING: National Surgical Quality Improvement Program-Pediatric Database. PARTICIPANTS: A total of 1720 patients met inclusion criteria for sec...
Source: The Cleft Palate-Craniofacial Journal - Category: ENT & OMF Authors: Tags: Cleft Palate Craniofac J Source Type: research
Conclusion: This procedure can be used to effectively solve: curvature of the costal cartilage segment itself; warping of the carved costal cartilage; and effective use of the costal cartilage segment. The procedure has achieved satisfactory outcomes, and its application is worth extending to clinical practice.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Clinical Studies Source Type: research
Rhinoplasty is the most challenging facial aesthetic surgical procedure according to many plastic surgeons. Nasal bone osteotomies, especially lateral osteotomies, have a complicated history. If lateral osteotomy is not stable after osteotomy during intraoperative period, stabilization is attempted with internal and external nasal splints but it is not possible to be confident about the stabilization since it is not fully fixed and cannot be observed directly. The authors presented the technique stabilization of the lateral osteotomy inferior tip with cerclage wire, if there is a stabilization problem or step-off deformity...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Brief Clinical Studies Source Type: research
CONCLUSIONS: Posterior cleft dimensions can be a modest indicator for the prognosis of velopharyngeal function at age 5 years, when the soft palate is closed first, independently on the timing of hard palate repair. Antero-posterior palatal length seems to protect from velopharyngeal insufficiency and hypernasality. However, the association found was significant but low. PMID: 31505955 [PubMed - as supplied by publisher]
Source: The Cleft Palate-Craniofacial Journal - Category: ENT & OMF Authors: Tags: Cleft Palate Craniofac J Source Type: research
The visibility of cartilage grafts underneath the skin is a complication of rhinoplasty particularly in patients with thin nasal skin. Preparing the graft with optimum dimensions, symmetry, and smoothness is crucial for the fine crafting of the cartilage to prevent visibility. The camouflage of the visible cartilage graft with a crushed cartilage, a resected cephalic portion of the lower lateral cartilage, fascia, connective and/or fatty tissues is another option for hiding the visibility. The nasal tip is the most common location where the graft visibility is of concern. The authors introduce the smoothing of the cartila...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Technical Strategies Source Type: research
Oculo-auriculo-fronto-nasal syndrome (OAFNS) is a rare anomaly characterized by features overlapping those of frontonasal dysplasia (FND) and the oculo-auriculo-vertebral spectrum (OAVS).1 The FND features malformation of frontonasal process-derived structures, characterized by anomalies in the central portion of the face. The OAVS is characterized by developmental anomalies of the first and second pharyngeal arches. The OAFNS is a condition with clinical features of both FND and OAVS. Here, the authors present the case of a male with OAFNS who not only exhibited typical OAFNS symptoms but also a dysplastic bony structure...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Brief Clinical Studies Source Type: research
Gender affirmation surgeries in male-to-female transition patients include breast augmentation, genital construction, and facial feminization. Facial features serve an integral role in identifying an individual's gender, with certain characteristics perceived as feminine or masculine. The nose, as the centerpiece of the middle third of the face, is an important component of facial attractiveness and gender identity. Thus, reduction rhinoplasty is a mainstay of the facial feature remodeling (FFRS) and facial feminization surgery (FFS). The authors usually divide the surgery planning in 2 steps, obviously depending on each...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
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Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
Introduction: Modern rhinoplasty has an aesthetic and a functional component that cannot be separated. Functional rhinoplasty generally concentrates on optimizing nasal airflow. Numerous techniques have been described for correction of each pathology. There seems to be a consensus on the benefit of surgery to patients with nasal obstruction. Present study aimed to determine if specific airway pathologies have differential effects on patient complaints and techniques addressing them have differential effects on perceived benefit from surgery. Patients/Method: The records of 300 patients complaining nasal obstruction an...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
The crooked nose is certainly among the most difficult to treat deformities for rhinoplasty surgeons. This deformity is a complex problem because each structural nasal component can be effected and they may be asymmetric bilaterally. Despite the use of sophisticated techniques and an additional effort, unfortunately the long-term aesthetic results may not be perfect with some minor flaws. Here in this study, the authors introduce a new technique that is used to correct crooked nose deformity. Sixteen consecutive patients who underwent open approach rhinoplasty by the same senior author between January 2015 and January 2018...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Clinical Studies Source Type: research
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