Management of Hypertelorism

AIM: To summarize the experience of the author with the treatment of hypertelorism. SETTINGS AND DESIGN: The author has been heading a high-caseload department of craniofacial surgery for 38 years; the research is based on his experience with this pathology by this time. MATERIALS AND METHODS: The charts of 38 patients were used for this research. STATISTICAL ANALYSIS USED: No statistic was used; the author has just given his personal insights as the result of a professional life devoted to the problem. RESULTS: Most of the hypertelorism cases requiring surgical correction are rare interorbital clefts (Tessier’s 14–12). Among the syndromic ones, cranio-fronto orbital dysplasia is the most demanding for surgery because it is associated with craniosynostosis, which has to be addressed at the same time. Among the technics published for hypertelorism correction, craniofacial bipartition has our preference for several reasons: easily done and redone when necessary, safer to the vascularization, and trophicity of displaced parts of the skeleton. CONCLUSIONS: Complex craniofacial conditions such as hypertelorism have to be treated only in specialized craniofacial centers by a multidisciplinary team. The caseload has to be high, and the follow-up is very strict to get the benefits of experience to improve the results.