Background

Orbital hypertelorism (OHT) represents a congenital condition defined by lateralization of the bony orbit, unlike soft tissue telecanthus in which there is an increase in intercanthal distance without true bony lateralization. Existing literature remains very limited in its postoperative assessment of bony versus soft tissue relapse, which may both clinically present as telecanthus. We performed a critical appraisal of the literature to determine the postoperative incidence of bony versus soft tissue relapse following OHT repair.

Methods

The PubMed, MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, and clinicaltrials.org were searched systematically for all English studies published in any time frame reporting relapse rates following primary OHT repair. The primary outcome was incidence of bony and soft tissue relapse defined as orbital lateralization and medial canthal drift, respectively. The secondary outcome measures include postoperative complications, predictors of postoperative complications, timing and type of surgery, and revision rates.

Results

Eleven articles were included. A total of 84 (35.3%) patients experienced bony relapse while 43 (27.2%) patients experienced soft tissue relapse. Age at time of intervention (p < 0.92), severity at presentation (p < 0.90), and surgical technique (p < 0.09) were not found be significantly associated with relapse rate. Methods for long-term follow-up were not standardized, and there was no consistent measure to objectively assess telecanthus.

Conclusions

There is no general consensus on predictive factors of long-term relapse following OHT repair in the form of box osteotomy or facial bipartition. These findings call for cross-sectional outcome standardization to better understand long-term outcomes across institutional, provider, and patient differences.

中文翻译：

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对眶距过远矫正后手术结果的批判性评估：真正的骨性复发与软组织远眦赘皮的发生率是多少？

背景

眶距过远 (OHT) 是一种由骨性眼眶偏侧定义的先天性疾病，与软组织远眦赘皮不同，后者在没有真正骨偏侧的情况下会增加眦间距离。现有文献在术后评估骨性与软组织复发方面仍然非常有限，这两种情况都可能在临床上表现为远眦赘皮。我们对文献进行了严格的评估，以确定 OHT 修复后骨与软组织复发的术后发生率。

方法

系统搜索了 PubMed、MEDLINE、EMBASE、Scopus、Cochrane Central Register of Controlled Trials 和clinicaltrials.org，以查找在任何时间范围内发表的所有报告初次 OHT 修复后复发率的英语研究。主要结果是骨和软组织复发的发生率，分别定义为眶侧化和内眦漂移。次要结局指标包括术后并发症、术后并发症的预测因素、手术时间和类型以及翻修率。

结果

包括十一篇文章。共有 84 名 (35.3%) 患者经历了骨性复发，而 43 名 (27.2%) 患者经历了软组织复发。干预时的年龄 ( p < 0.92)、就诊时的严重程度 ( p < 0.90) 和手术技术 ( p < 0.09) 未发现与复发率显着相关。长期随访的方法不规范，也没有一致的措施来客观地评估远眦赘皮。

结论

对于以箱形截骨术或面部二分术形式进行 OHT 修复后长期复发的预测因素尚无普遍共识。这些发现要求横断面结果标准化，以更好地了解机构、提供者和患者差异的长期结果。