Mm. Cohen et al., HYPERTELORISM - INTERORBITAL GROWTH, MEASUREMENTS, AND PATHOGENETIC CONSIDERATIONS, International journal of oral and maxillofacial surgery, 24(6), 1995, pp. 387-395
Normal pre- and post-natal changes in the interorbital distance are de
scribed. Causes of illusory hypertelorism include flat nasal bridge, e
picanthic folds, exotropia, widely-spaced eyebrows, narrow palpebral f
issures, and dystopia canthorum. Measurements of hypertelorism may inv
olve soft tissues or bone, and a number of indices have also been prop
osed. Various types of measurements are evaluated and recommendations
suggested. Possible pathogenetic mechanisms for hypertelorism include:
early ossification of the lesser wings of the sphenoid; failure in na
sal capsule development allowing the primitive brain vesicle to protru
de into the space normally occupied by the capsule resulting in morpho
kinetic arrest in the position of the eyes; and disturbances of the cr
anial base in Apert syndrome. Associations with increased interorbital
distance are also discussed: orofacial clefting, nonprotruding lipoma
s of the corpus callosum, calcification of the fair cerebri, duplicati
on of the crista galli, wrinkling of the nose, and tissue tags of the
nose. Finally, experimental models of hypertelorism in animals are dis
cussed.