Globe and eyelid positional changes induced by monobloc frontofacial advancement with distraction osteogenesis

The literature on the effect of monobloc frontofacial advancement on exorbitism correction and palpebral fissure shape is none. Using image processing software we measured, in patients who underwent monobloc advancement, the effect of the surgery on the correction of exorbitism (n = 38) and on the position of the upper and lower eyelids as well on the palpebral fissure slant (n=18). The results indicate that monobloc has a symmetrical effect on the globe protrusion that is correlated to the preoperative degree of exorbitism. Longitudinal data indicate that exorbitism correction changes with time and a certain degree of enophthalmos in the early postoperative period does not necessarily imply a sustained overcorrection. The exorbitism reduction induced by monobloc advancement is accompanied by a diminution of the distance between both eyelids and the pupil center and an increment of the downward slant of the palpebral fissure.