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Downloaded from http://journals.lww.com/jcraniofacialsurgery by BhDMf5ePHKbH4TTImqenVA5KvPVPZ0P5BEgU+IUTEfzO/GUWifn2IfwcEVVH9SSn on 06/03/2020 ORIGINAL ARTICLE Correction of Complex Neurofibromatosis Orbital and Globe Malposition Using the Orbital Box Segmentation Osteotomy With Patient-Specific Internal Orbit Reconstruction yz z Edward H. Davidson, MD, Nima Khavanin, MD, Michael Grant, MD, PhD, and Anand R. Kumar, MD postoperatively. One patient had surgical site infection, there is Introduction: Correction of severe orbital and globe malposition no evidence of relapse at mean 24-months follow-up. from neurofibromatosis remains a significant clinical challenge. Conclusion: Segmental box osteotomy with internal orbital Current techniques including zygoma osteotomy, bone grafting, or reconstruction redistributes orbital volume safely and accurately placement of orbital implants do not adequately address aberrant addresses globe malposition from neurofibromatosis. anatomy, under-correct the deformity, and are prone to relapse. The authors have developed the orbital box segmentation osteotomy to reduce vertical orbital height and translocate the orbit and use Key Words: Dystopia, neurofibromatosis, orbit, osteotomy, patient-specific custom internal orbital titanium implants to close virtual surgical planning the cranio-orbital communication—reestablishing both the external (J Craniofac Surg 2019;30: 1647–1651) orbital shape and internal orbital volume. Methods: Virtual surgical planning with contralateral mirror eurofibromatosis type 1 (NF1) is an autosomal-dominant imaging was used to design symmetrical repositioning of
Journal of Craniofacial Surgery – Wolters Kluwer Health
Published: Sep 1, 2019
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