Posttraumatic pseudohypertelorism. (Telecanthus)

Telecanthus was evaluated in a large series of patients with midfacial trauma. Nine patients were selected for detailed analysis of cause, degree of injury, and results of surgical treatment. The evaluation suggests that fractures causing the medial canthal injury are extensive, often resulting in ocular and CNS damage. Late repairs are plagued with difficulty in identification of the ligament and mobilization of soft tissues in the medial canthal area. Satisfactory function and appearance can usually be obtained by early exploration of the injury, reduction of bone fragments, and restoration of the medial canthal ligament to its normal position.

Blepharo-canthal deformities in patients following craniofacial surgery

Functional problems and deformities of the eyes have become a major concern in the surgical treatment of ortital hypertelorism and craniofacial dysostosis, as experience with skeletal relocation for these disorders has been gained. Comprehensive preoperative and postoperative study and measurements of the bony orbits, the globes, the lids, the canthi, and the nose are necessary for the evaluation of present techniques and the design of alternative procedures. Some of the deformities of the blepharo-canthal complex are part of the congenital malformation. Other distortions, seen only postoperatively, are secondary to specific surgical maneuvers. Awareness of these primary and secondary factors has led to better soft tissue reconstruction at the time of the bony orbital translocations or the craniofacial disjunction. We describe the techniques which we have found especially useful in avoiding and correcting these postoperative blepharocanthal deformities.

Ocular abnormalities in the median cleft face syndrome

An 8-month-old infant boy with median facial cleft syndrome had eyelid coloboma, symblepharon, and a cytic mass in the left upper eyelid. The mass proved to be an ectatic cornea containing a large cystic lens. Maldevelopment of the entire anterior segment of the eye was also present, although the posterior globe was well formed. We postulate that an area of localized abnormal mesodermal differentiation and fusion at the 17- to 20-mm stage of development served as a common mechanism for all the defects noted.

Craniofacial reconstruction: ocular management of orbital hypertelorism

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