Surgical Treatment of Orbital Hypertelorism

The term orbital hypertelorism (OrH) implies “widely apart orbits.” This may also be associated with the abnormal vertical orientation of the orbits (dystopia). This deformity may be unilateral or bilateral, symmetric or asymmetric and may be present in a variety of craniofacial anomalies. The surgical treatment is primarily carried out for aesthetic and psychosocial reasons. The timing of surgical treatment is dictated by the underlying condition and the type of procedure envisaged. The mainstay of treatment consists of moving the orbits medially to near normal position. This is accomplished by either an orbital translocation (box osteotomies) or facial bipartition technique. The choice of procedure is governed by the shape of the maxillary arch and associated occlusal conditions. Orbital hypertelorism involves extensive intracranial and extracranial operation. This chapter will discuss the aetiology, classification, presentation, treatment options, timing of surgery and the choice of surgical procedures.