Hypertelorism: the importance of three-dimensional imaging and trends in the surgical correction by facial bipartition.
BACKGROUND
The technique of facial bipartition has been considered a great advance in achieving a more natural appearance in hypertelorism correction.


METHODS
Fourteen patients who had undergone hypertelorism correction by facial bipartition were retrospectively studied to analyze the role of three-dimensional computed tomographic reconstruction in the evaluation of the deformity and preoperative planning. The procedure and surgical details that can improve the outcome were described. A reproducible set of three-dimensional measurements that can help in preoperative patient evaluation was determined based on information obtained using the Analyze/AVW 3.1 system (Biomedical Imaging Resource, Mayo Foundation, Rochester, Minn.).


RESULTS
In this series, the most common diagnosis was frontonasal dysplasia (64.3 percent). Five patients had second-degree (35.7 percent) and nine had third-degree hypertelorism (64.3 percent). The three-dimensional scans were shown to be highly accurate in predicting the degree of deformity. There was a significant difference in the preoperative and postoperative interdacryon distance and midface height (p < 0.05) but not in the bitemporal distance (p = 0.08). The simulation correlated significantly with the postoperative result when interdacryon distance and midface height were analyzed (0.736 and 0.999).


CONCLUSIONS
Facial bipartition provided a three-dimensional correction of hypertelorism. Three-dimensional imaging can definitely be considered an extra tool for accurate surgical planning and helping the family understand the surgical procedure and the end result.
Moreira Gonzalez
Andrea
A
Institute for Craniofacial and Reconstructive Surgery, Southfield, Mich 48084, USA.
Elahi
Mohammed
M
Barakat
Khaled
K
Yavuzer
Reha
R
Brinkmann
Ben
B
Jackson
Ian T
IT
D000168:Acrocephalosyndactylia / Q000601:surgery; D016025:Bone Transplantation; D002648:Child; D002675:Child, Preschool; D003394:Craniofacial Dysostosis / Q000601:surgery; D005147:Facial Bones / Q000601:surgery*; D005260:Female; D006801:Humans; D006972:Hypertelorism / Q000000981:diagnostic imaging* / Q000601:surgery*; D021621:Imaging, Three-Dimensional; D008297:Male; D008437:Maxilla / Q000601:surgery; D010027:Osteotomy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D015050:Zygoma / Q000601:surgery