Modification of Orbital Osteotomy in Midfacial Advancement
In surgical correction of hypertelorism and also in Le Fort III osteotomies, which are carried out through a coronal incision, the osteotomy line is usually in the middle of the orbital funnel. When the osteotomy of the medial orbital wall is taken down to the orbital floor the nasolacrimal apparatus can be identified; in most instances the detachment of the medial canthal ligaments is also performed at that time. Since the lateral canthal ligament also has to be severed during the subperiostal dissection of the orbital content, the two can-thai tendons are then no longer supported on the orbital walls (Fig. 1).
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