Correction of ocular hypertelorism

Area of Science:

• Craniofacial Surgery
• Plastic Surgery
• Neurosurgery

Background:

• Congenital hypertelorism, Crouzon's disease, and posttraumatic deformities present significant cosmetic and functional challenges.
• Surgical correction often involves complex procedures with potential risks.
• The Tessier technique is a foundational approach for craniofacial reconstruction.

Purpose of the Study:

• To evaluate the efficacy and safety of a modified Tessier technique for correcting craniofacial deformities.
• To assess the impact of the modification on operative time and patient outcomes.
• To report on the complication profile and cosmetic results of the surgical approach.

Main Methods:

• A modified Tessier technique was employed in 36 patients with hypertelorism, 8 with Crouzon's disease, and 3 with posttraumatic deformities.
• The modification involved not separating the dura from the cribriform plate to prevent olfactory nerve damage.
• Surgical procedures were timed, and patient outcomes, including complications and cosmetic results, were meticulously recorded.

Main Results:

• Operative times were under 5 hours for hypertelorism correction and 6-8 hours for Crouzon's disease.
• One intraoperative anesthetic death occurred in a pediatric patient; one cardiac arrest was successfully resuscitated.
• Superficial Staphylococcus infections (9), postoperative cerebral edema (1), and convulsions (1) were managed; no CSF fistulas were observed.

Conclusions:

• The modified Tessier technique offers a viable approach for correcting complex craniofacial deformities.
• Preserving the dura-cribriform plate connection may mitigate olfactory complications.
• Excellent cosmetic outcomes were achieved, underscoring the importance of surgical expertise in craniofacial reconstruction.