THE CONCEPT OF THE SAGITTAL ORBITAL-GLOBE RELATIONSHIP IN CRANIOFACIAL SURGERY

Euophthalmos, the normal relationship of the orbital rims to the eyes, is critical to planning and to surgical correction of craniofacial de formities. The four most easily localized anthropometric (soft tissue) landmarks for the sagittal orbital-globe relationship are orbitale su perius (os), orbitale inferius (oi), orbitale laterale (ol), and nasio n (n), all referenced to apex corneae (acor). The normal adult values for os, oi, ol, and n were extracted from the literature. Age-specific anthropometric landmarks were computed from age-specific Bolton cepha lometric templates. A vernier caliper was used to measure preoperative ly the surface orbital landmarks in patients with various syndromic an d nonsyndromic craniosynostotic disorders. Preoperative measurements w ere compared with the derived normative data to determine the necessar y sagittal orbital translocation for frontal advancement (n = 19) and frontal-midfacial advancement (n = 2). Postoperative orbital anthropom etry documented the degree of normalization of the sagittal orbital-gl obe relationship. The problems with current instrumentation for orbita l anthropometry are discussed.