A Rare Orbital Complication of Eye Exodeviation with Limited Abduction during Monobloc Le Fort III Distraction Osteogenesis. (July 2015)

• Record Type: Journal Article
• Authors: Hariri, Firdaus; Cheung, Lim Kwong; Rahman, Zainal Ariff Bin Abdul; Ramasamy, Sundrarajan Naidu; Ganesan, Dharmendra
• Is Part Of: Cleft palate-craniofacial journal. Volume 52:Number 4(2015)
• Page Start: 489
• Page End: 493
• Publication Date: 2015-07
• Subjects: craniofacial surgery -- Crouzon syndrome -- distraction osteogenesis -- monobloc Le Fort III -- orbital complication; Cleft palate -- Periodicals; Skull -- Abnormalities -- Periodicals; Cranial manipulation -- Periodicals; Skull -- Abnormalities -- Surgery -- Periodicals; Face -- Abnormalities -- Surgery -- Periodicals; Fente palatine -- Périodiques; Crâne -- Malformations -- Périodiques; Manipulation crânienne -- Périodiques; Crâne -- Malformations -- Chirurgie -- Périodiques; Face -- Malformations -- Chirurgie -- Périodiques; Cleft palate; Cranial manipulation; Face -- Abnormalities -- Surgery; Skull -- Abnormalities; Skull -- Abnormalities -- Surgery; Cleft Lip; Cleft Palate; Facial Bones -- abnormalities; Skull -- abnormalities; Periodicals; Periodicals; Periodicals; 617.522
• DOI: 10.1597/14-013
• Languages: English
• ISSNs: 1055-6656

Abstract

Monobloc Le Fort III distraction osteogenesis allows superior skeletal advancement in treating severe syndromic craniosynostosis. We report a rare orbital complication in a 3-year-old boy with Crouzon syndrome who developed right-eye exodeviation with limited abduction during the intradistraction period following this surgery. Images from a computed tomography scan confirmed direct impingement of the distracted right lateral orbital wall to the lateral rectus muscle. The impingement was surgically relieved via lateral orbital wall osteotomy. Ten months postdistraction, a review showed normal eye movement. A lateral orbital osteotomy cut for a monobloc Le Fort III distraction should be designed near the rim to prevent this complication.