Schultz-Coulon H J
HNO. 1980 Mar;28(3):85-90.
Following naso-orbital fractures, posttraumatic hypertelorism (or telecanthus) cannot always be avoided, even when prompt surgical treatment is given. For correction of this deformity, attempted remobilisation of the injured nasal skeleton (with or without grafting) is rarely successful. This is so because of two reasons: (1) the lateral nasal wall is thickened by overlapping fragments of fractured bone so that excessive scar tissue cannot be adequately replaced; (2) revision of paranasal sinus drainage is needed in most cases. Three cases are reviewed in order to demonstrate our concept of surgical repair: complete removal of bony fragments and scar tissue between lateral nasal mucosa and periorbita, restoration of the contour of the bony bridge of the nose by cartilage grafting and median canthoplasty, as well as possible pan-sinusectomy with or without dacryocystorhinostomy when needed.