overview of oestotomies for hypertelorism

[Faaska]

Technique	Pros	Cons	Methdolodgy
360-Degree Orbital Box Osteotomy	- Maximum orbital mobilization and control. - Effective for severe hypertelorism. - Precise correction of interorbital distance. - Addresses associated craniofacial deformities.	- Highly invasive and technically complex. - Longer operative time. - Higher risk of complications - Requires significant surgical expertise.
180-Degree Orbital Box Osteotomy	- Less invasive than 360-degree osteotomy. - Effective for moderate hypertelorism. - Shorter operative time. - Reduced risk of complications compared to 360-degree osteotomy.	- Limited orbital mobilization. - Less effective for severe hypertelorism. - May not address associated craniofacial deformities as comprehensively.	N.A
Spectacle Osteotomy	- Designed specifically for hypertelorism correction. - Allows for simultaneous correction of orbital dystopia. - Good cosmetic outcomes.	- Technically challenging - Risk of orbital and intracranial complications. - Limited applicability in severe cases. - More preferred for younger patients.
Facial Bipartition	- Corrects hypertelorism and midface deformities simultaneously. - Improves facial symmetry and occlusion.	- Highly complex procedure. - Requires significant expertise. - Higher risk of complications (e.g., bleeding, infection). - Longer recovery time. - Technically challenging - Risk of orbital and intracranial complications. - Limited applicability in severe cases. - More preferred for younger patients.
Medial Wall Osteotomy Preferably combined with lateral orbital wall implantation	- Minimal invasiveness. - Suitable for mild hypertelorism. - Shorter operative time and recovery. - Lower risk of complications - Can be aided via a bone graft if necessary although not common - Safest option on this list (typical orbital box oestotomy and bipartion have death rates ~2-3% based off memory)	- Limited correction capability. - Not effective for moderate or severe hypertelorism. - Does not address associated craniofacial deformities like mid face hypoplasia.

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Considerations:​

• Severity of Hypertelorism:
  • Mild (30-34mm iod) : Medial wall osteotomy with lateral augmentation or 180-degree orbital box osteotomy if you wanna be dumb
  • Moderate to Severe (35mm+ iod) : 360-degree orbital box osteotomy, spectacle osteotomy, or facial bipartition or 180 degree if applicable.
  • Be mindful that iod is usually 3-6mm less than icd and ct scans are necessary for confirmation
• Surgical methodology : Complex procedures require highly skilled craniofacial surgeons, ensure there is proper planning done for your surgery including adequate ct scans and use of guides avoid any butchers interesting read on designing surgery
• You will need post surgery checkups to correct any potential changes in the face especially soft tissue or nose

@RealSurgerymax pls review
@Lefor3Laser

 

[BimaxLaser]

A molecule

 

[Faaska]

Technique	Pros	Cons	Methdolodgy
360-Degree Orbital Box Osteotomy	- Maximum orbital mobilization and control. - Effective for severe hypertelorism. - Precise correction of interorbital distance. - Addresses associated craniofacial deformities.	- Highly invasive and technically complex. - Longer operative time. - Higher risk of complications - Requires significant surgical expertise.	View attachment 3464401
180-Degree Orbital Box Osteotomy	- Less invasive than 360-degree osteotomy. - Effective for moderate hypertelorism. - Shorter operative time. - Reduced risk of complications compared to 360-degree osteotomy.	- Limited orbital mobilization. - Less effective for severe hypertelorism. - May not address associated craniofacial deformities as comprehensively.	N.A
Spectacle Osteotomy	- Designed specifically for hypertelorism correction. - Allows for simultaneous correction of orbital dystopia. - Good cosmetic outcomes.	- Technically challenging - Risk of orbital and intracranial complications. - Limited applicability in severe cases. - More preferred for younger patients.	View attachment 3465163
Facial Bipartition	- Corrects hypertelorism and midface deformities simultaneously. - Improves facial symmetry and occlusion.	- Highly complex procedure. - Requires significant expertise. - Higher risk of complications (e.g., bleeding, infection). - Longer recovery time. - Technically challenging - Risk of orbital and intracranial complications. - Limited applicability in severe cases. - More preferred for younger patients.	View attachment 3465173
Medial Wall Osteotomy Preferably combined with lateral orbital wall implantation	- Minimal invasiveness. - Suitable for mild hypertelorism. - Shorter operative time and recovery. - Lower risk of complications - Can be aided via a bone graft if necessary although not common - Safest option on this list (typical orbital box oestotomy and bipartion have death rates ~2-3% based off memory)	- Limited correction capability. - Not effective for moderate or severe hypertelorism. - Does not address associated craniofacial deformities like mid face hypoplasia.	View attachment 3465181 View attachment 3465183

---

Considerations:​

• Severity of Hypertelorism:
  • Mild (30-34mm iod) : Medial wall osteotomy with lateral augmentation or 180-degree orbital box osteotomy if you wanna be dumb
  • Moderate to Severe (35mm+ iod) : 360-degree orbital box osteotomy, spectacle osteotomy, or facial bipartition or 180 degree if applicable.
  • Be mindful that iod is usually 3-6mm less than icd and ct scans are necessary for confirmation
• Surgical methodology : Complex procedures require highly skilled craniofacial surgeons, ensure there is proper planning done for your surgery including adequate ct scans and use of guides avoid any butchers interesting read on designing surgery
• You will need post surgery checkups to correct any potential changes in the face especially soft tissue or nose

@RealSurgerymax pls review
@Lefor3Laser

any advice or added info thanks

 

[Lefor3Laser]

Technique	Pros	Cons	Methdolodgy
360-Degree Orbital Box Osteotomy	- Maximum orbital mobilization and control. - Effective for severe hypertelorism. - Precise correction of interorbital distance. - Addresses associated craniofacial deformities.	- Highly invasive and technically complex. - Longer operative time. - Higher risk of complications - Requires significant surgical expertise.	View attachment 3464401
180-Degree Orbital Box Osteotomy	- Less invasive than 360-degree osteotomy. - Effective for moderate hypertelorism. - Shorter operative time. - Reduced risk of complications compared to 360-degree osteotomy.	- Limited orbital mobilization. - Less effective for severe hypertelorism. - May not address associated craniofacial deformities as comprehensively.	N.A
Spectacle Osteotomy	- Designed specifically for hypertelorism correction. - Allows for simultaneous correction of orbital dystopia. - Good cosmetic outcomes.	- Technically challenging - Risk of orbital and intracranial complications. - Limited applicability in severe cases. - More preferred for younger patients.	View attachment 3465163
Facial Bipartition	- Corrects hypertelorism and midface deformities simultaneously. - Improves facial symmetry and occlusion.	- Highly complex procedure. - Requires significant expertise. - Higher risk of complications (e.g., bleeding, infection). - Longer recovery time. - Technically challenging - Risk of orbital and intracranial complications. - Limited applicability in severe cases. - More preferred for younger patients.	View attachment 3465173
Medial Wall Osteotomy Preferably combined with lateral orbital wall implantation	- Minimal invasiveness. - Suitable for mild hypertelorism. - Shorter operative time and recovery. - Lower risk of complications - Can be aided via a bone graft if necessary although not common - Safest option on this list (typical orbital box oestotomy and bipartion have death rates ~2-3% based off memory)	- Limited correction capability. - Not effective for moderate or severe hypertelorism. - Does not address associated craniofacial deformities like mid face hypoplasia.	View attachment 3465181 View attachment 3465183

---

Considerations:​

• Severity of Hypertelorism:
  • Mild (30-34mm iod) : Medial wall osteotomy with lateral augmentation or 180-degree orbital box osteotomy if you wanna be dumb
  • Moderate to Severe (35mm+ iod) : 360-degree orbital box osteotomy, spectacle osteotomy, or facial bipartition or 180 degree if applicable.
  • Be mindful that iod is usually 3-6mm less than icd and ct scans are necessary for confirmation
• Surgical methodology : Complex procedures require highly skilled craniofacial surgeons, ensure there is proper planning done for your surgery including adequate ct scans and use of guides avoid any butchers interesting read on designing surgery
• You will need post surgery checkups to correct any potential changes in the face especially soft tissue or nose

@RealSurgerymax pls review
@Lefor3Laser

Mirin tbh, i am curious on what Liam would say about this, wich one that is his preferable.

 

[Faaska]

Mirin tbh, i am curious on what Liam would say about this, wich one that is his preferable.

im guessing 180/subcranial box oestotomy idk if he has experience w medial wall oestotomy