Surgical treatment of craniofacial cleft and orbital hypertelorism: a single-center cohort study.

Objective: Craniofacial clefts, characterized by congenital disruptions in the development of facial and cranial tissues, often present alongside orbital hypertelorism (ORH), an abnormal increase in the interorbital distance. These conditions pose significant challenges in craniofacial surgery due to the complex anatomical and functional considerations involved. This single-center cohort study retrospectively analyzed 22 patients diagnosed with craniofacial cleft syndromes and ORH who were treated at the Craniofacial Centre, Fatima Plastic and Reconstructive Surgery Hospital between July 2016 and October 2023.

Methods: This study outlines the preoperative evaluations, surgical interventions, and postoperative outcomes of these cases. Surgical techniques varied according to the severity and type of deformity, guided by Tessier's classification system. Procedures included spectacle osteotomy, box osteotomy, and facial bipartition osteotomy, with each approach tailored to address the unique anatomical challenges presented by ORH and associated craniofacial anomalies.

Results: There was a 9% incidence of postoperative infections and a 22.7% incidence of CSF leakage, with a subset of these leading to meningitis. These complications underscore the complexity of managing craniofacial clefts and ORH, highlighting the necessity for meticulous surgical planning and postoperative care.

Conclusions: Despite the challenges, the study demonstrates that individualized, protocol-driven surgical interventions can achieve significant aesthetic and functional improvements in patients with these congenital anomalies.