Am I A Good Candidate for 180 Degree Orbital Box Osteotomies?

Q: Dr. Eppley, But was curious about the 180* orbital box osteotomy for orbital widening/interpupilar distance increase.

A:For the patient who has decreased interpupillary distance 360° orbital box osteotomies will make a significant difference (8 to 10mms). The question is not whether that would be the correct operation but whether the patient’s level of motivation is such that they are you willing to undergo the transcoronal incision and the front craniotomy that is needed to adequately perform this procedure. There are alternatives to this classic approach that does not need a frontal craniotomy which is more of a 180° orbital box osteotomy, as you have mentioned, which moves the lateral and inferior orbital rims more laterally. It’s effectiveness is not as profound as the 360° version, a 3 to 5mm IPD increase, but does spare the need for a frontal craniotomy and medial wall orbital osteotomies.

Dr. Barry Eppley

Plastic Surgeon