ABSTRACT
Orbital hypertelorism is a physical finding associated with a number of congenital midline anomalies: craniofrontonasal dysplasia, frontonasal dysplasia, encephalocele, midline dermoid cyst, syndromes characteristic of midface retrusion and craniosynostosis (e.g. Apert and Crouzon syndromes), and atypical midline cleft anomalies. Though all patients with hypertelorism exhibit some telecanthus, not all patients with telecanthus are hyperteloric. These anomalies characteristically cause widening of the upper craniofacial segment and orbital hypertelorism. Generally, these are nonprogressive entities and best addressed once the cranioorbital units are near skeletal maturity (5–8 years of age). The extent and location of facial widening dictates which procedure is performed: box osteotomies versus facial bipartition. Rowe forceps and Seldins are simultaneously used to achieve a controlled disimpaction of the two halves of the face, which are then rotated to the midline. Due to rotation after mobilization, triangular shaped wedges are removed from the lateral orbital rims for a more appropriate fit against the frontal bone.
