Surgical correction of orbital and periorbital deformities using lamella and complex osteotomies in both orbital rim and wall.

摘要

PURPOSE: For dealing with the problems in orbital and periorbital deformities. METHODS: In orbital deformities such as hypertelorism, orbital dystopia, radiated orbit, and secondary deformities of traumatic orbit, the authors used lamella osteotomies of either orbital rim and wall or complex osteotomies in both adjacent orbital rims and walls with bicoronal incision and galea aponeurotica dissection. In most of the cases, the fragments of complex osteotomies were repositioned with rigid fixation. RESULTS: Best results with nearly normal orbital volumes, better contour of orbit and midface, and improved eyelids and vision were achieved in 44 cases. There were 5 cases of supraorbital osteotomy (intracranial routine), 8 cases of medial orbital osteotomy, 3 cases of inferior orbital osteotomy, and 28 cases of both lateral and inferior orbital osteotomy in the series. No complications occurred. Clinical measurement was achieved in both pre- and postoperative osteotomies. According to comparative recordings,such as cephalometric measurement of the interorbital distance, exophthalmic measurement with Hertel exophthalmometer, the angle between orbital horizontal level and bilateral tragus linkage, and the linear distance between lateral canthus and tragus, the gap difference between pre- and postoperative data were achieved. The orbital and midface appearance has improved significantly. CONCLUSIONS: Lamella and complex osteotomies of orbital rim and wall were proved to be save and effective for correction of most deformities of the orbital and periorbital region.