Surgery for orbital osteomas

Eleven patients with orbital osteomas [three primary orbital and eight originating from adjacent paranasal sinuses with secondary extension into orbit], were treated surgically through a craniofacial approach [8 patients] and degloving mid-face procedure [3 patients]. Osteotomies of the orbital, nasal or maxillary walls were performed to get access into the lesion followed by replacement of the osternatized bone. Immediate reconstruction of the resulting bone defects were performed which helped in preservation of both the function and appearance of the involved orbit. Complete removal of the orbital osteomas was aschieved in all patients with minimal postoperative complications

Fronto-orbital advancement and cranial vault remodeling for craniosynostosis

Twenty-eight patients with different types of synostoses had been operated upon during a period of four years, the average age at the time of surgery was two years. Through an intra-cranial approach the deformed cranio-facial skeleton was managed by cranial and orbital ostotomies with reshaping, repositioning and advancement to give the child the appropriate cranio-facial form with increase in both the cranial and orbital volumes. The resulting cranio-facial form, according to the classification of Whitaker and associates 1987, showed that 19 patients were in category 1, 3 patients in category 2, 4 patients in category 3 and 2 patients in category 4. Reoperation was necessary in only 2 patients, no major or life threatening complications were encountered in this series. Correction of this deformity is recommended at an early age, preferably the second half of the first year of life to make use of the enlarging and growing brain in improving and maintaining the result obtained both functionally and esthetically