Transnasal canthoplasty

The reconstruction of a traumatic telecanthus, particularly the repositioning and securing of the medial canthal tendon, presents a challenge to the reconstructive surgeon. The adequate positioning of the medial canthal tendon for proper intercanthal distance, and apposition of the lid to the globe, is the cornerstone of a successful reconstruction. The authors have developed a technique for transnasal canthoplasty that is fast, relatively easy, and safe. Transnasally, a 16-gauge spinal needle is introduced over a preplaced K-wire using a 4-0 Bunnell stainless wire suture (Ethicon, Somerville, NJ). The medial canthal tendon is lassoed, secured, and then fixed to the contralateral nasal bone. Six patients have undergone this technique to date. The authors believe this procedure offers an improvement to existing methods.