Lateral Orbital Rim Advancement and Balanced Orbital Decompression for Exorbitism Regression in Crouzon Syndrome

Crouzon syndrome is a syndromic craniosynostosis characterized by brachycephaly, midfacial hypoplasia, exorbitism, and malocclusion. Although current treatments can effectively address these deformities, they generally involve extensive staged procedures associated with prolonged treatment duration and substantial financial cost. For postpubescent and adult patients with relatively mild manifestations whose primary concern is noticeable exorbitism, less invasive options are limited. We describe a minimally invasive technique termed lateral orbital rim advancement combined with balanced orbital decompression (LORA-BOD), designed to improve exorbitism and periorbital contour. Three patients treated with this technique showed measurable reductions in globe protrusion, with no complications observed during follow-up. Mean reductions were 7.25 ± 1.97 mm on Hertel exophthalmometry, and 3.62 ± 1.65 mm or 4.29 ± 2.41 mm on computed tomography, measured as the distance from corneal apex to the interzygomatic line and orbitale, respectively. Exotropia also improved postoperatively, contributing to enhanced function and appearance. Overall, this technique demonstrates favorable efficacy in reducing exorbitism in Crouzon syndrome and may serve as a targeted adjunctive option for patients with localized periorbital concerns.