[Surgical correction of exophthalmos in craniofacial synostosis].
OBJECTIVE
To analyze the efficacy and complications of the surgical correction of exophthalmos in craniofacial synostosis.


METHODS
Three different procedures were used in exophthalmos patients with different ages. In patients aged 1 - 3 years old, the fronto-orbital advancing osteotomy to deepen the upper part of orbital cavity was employed. In patients aged 4 - 15 years old, Le Fort III osteotomy and distraction osteogenesis were selected. In patients aged 16 years old or more, Le Fort III osteotomy or monobloc craniofacial osteotomy with immediately advancement of the midface segments were selected.


RESULTS
Good results were achieved for all 18 patients. The proptosis reduced 7.8 mm postoperatively. The depth of the skull base increased 8.2 mm and inferior orbit margin was advanced 7.8 mm as compared with the preoperative measurements. The angle between the maxilla and skull base (SNA) increased 9 degree. All of these measurements indicated that the proptosis and craniofacial contouring were approached to the normal situation after surgical intervention.


CONCLUSIONS
Both immediate advancement and gradual distraction after frontal, orbital, and maxillar osteotomy to enlarge the orbital cavities are the best approaches for the treatment of exophthalmos in craniofacial synostosis.
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Second Medical University, Shanghai 200011, China. cranio@citiz.net
Xiong-zheng
XZ
Mu
Jing
J
Ji
Yi-min
YM
Wang
Ru-hong
RH
Zhang
Min
M
Wei
Sheng-zhi
SZ
Feng
Di-sheng
DS
Zhang
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003394:Craniofacial Dysostosis / Q000150:complications* / Q000601:surgery; D005094:Exophthalmos / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019857:Osteogenesis, Distraction / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods*; D019651:Plastic Surgery Procedures