[Malposition of the orbita from the surgical point of view]

The individual appearance of a person is mainly determined by the head and, in particular, by the eyes. The orbita exerts a decisive influence on the harmony of the face. Anomalies of the neuro- and viscerocranium have varying impact on the orbits as well as on the structures of the bulb, resulting in dysmorphia or dystopia of the orbits which, in turn, lead to corresponding functional impairments. Premature craniosynostoses, representing the most frequent craniofacial malformation, may have an influence on the region of the orbita in different manner. Symptomatics depend on localisation, number and severity of the synostoses. Main symptoms are uni- or bilateral exophthalmus as well as hypo- or hypertelorism. The deformation of the patients is not only a "cosmetic problem" but often also a barrier to social communication with all consequent impairments of the patient's development. Sometimes it is even the only reason for a mental retardation of the child. Apart from augmentation of the intracranial volume, the main aim of corrective surgery, therefore, is normalisation of the patient's appearance. There are various surgical procedures for operative correction. However, therapy is not only directed towards the orbita but has to be integrated into the overall concept for therapy of the disease. In this article we show the surgical approaches for the treatment of orbital malformations caused by various craniofacial malformations, using clinical examples.