Customized guided box osteotomies in pediatric patients with orbital hypertelorism
Orbital hypertelorism is a rare and surgically demanding craniofacial anomaly requiring highly accurate three-dimensional repositioning of the orbital complexes. This retrospective case series reports the use of virtual surgical planning with patient-specific cutting guides for orbital box osteotomy...
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| Autori principali: | , , , , , , , , , |
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| Natura: | Article (Journal) |
| Lingua: | inglese |
| Pubblicazione: |
July 2026
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| In: |
Journal of cranio-maxillofacial surgery
Year: 2026, Volume: 54, Fascicolo: 7, Pages: 1-7 |
| ISSN: | 1878-4119 |
| DOI: | 10.1016/j.jcms.2026.104563 |
| Accesso online: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.jcms.2026.104563 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1010518226001204 
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| Note sull'autore: | Simon Bigus, Steffen Koerdt, Matthias Schulz, Tim Lukas Elter, Carolin Bestendonk, Michael Schwaiger, Paul Frederic Kaiser, Ulrich-Wilhelm Thomale, Max Heiland, Tobias Ebker |
| Riassunto: | Orbital hypertelorism is a rare and surgically demanding craniofacial anomaly requiring highly accurate three-dimensional repositioning of the orbital complexes. This retrospective case series reports the use of virtual surgical planning with patient-specific cutting guides for orbital box osteotomy in five pediatric patients (mean age at surgery 5.8 years; range 5-8 years) treated at a tertiary craniofacial center between 2021 and 2024. Osteotomy and ostectomy lines were planned on CT data and transferred intraoperatively using customized fronto-orbital and infraorbital guides, followed by medialization of the orbital boxes, rigid fixation, and medial canthopexy. Mean interorbital distance was reduced from 34.7 ± 2.66 mm to 19.06 ± 2.95 mm (mean reduction 45.3%). Surgical transfer accuracy was high, with a root mean square deviation of 0.40 mm between planned and postoperative dacryon distances. No postoperative infections, intracranial hemorrhages, material failure, or plate displacement occurred; one patient developed new-onset strabismus. Despite substantial bony correction, mild residual pseudo-hypertelorism remained clinically apparent in all patients, highlighting the relevance of soft-tissue limitations. Patient-specific guided workflows enabled precise and reproducible skeletal correction and may support predictability in complex and revision craniofacial procedures. |
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| Descrizione del documento: | Online verfügbar: 10. April 2026, Artikelversion: 10. April 2026 Gesehen am 26.05.2026 |
| Descrizione fisica: | Online Resource |
| ISSN: | 1878-4119 |
| DOI: | 10.1016/j.jcms.2026.104563 |