Experience with transnasal canthopexy.

The results are presented of a series of 14 canthopexies in recent trauma cases, 15 for correction of post-traumatic canthal dystopy, 12 for correction of hypertelorism and 8 in Le Fort III midface advancements. The overall results in traumatic cases are acceptable, in hypertelorism a considerable amount of relapse is noted and in Le Fort III osteotomies intercanthal distance enlarges slightly. The reasons for unsatisfactory results are discussed: Pressure ulcers of the skin, lateral pull of the soft tissues, and exaggerated pull on the ligaments seem to be the main factors. In Le Fort III osteotomies the anatomical situation has to be considered. As a conclusion it is suggested that the canthal ligaments should not be detached whenever possible in cases in which the topographical relationship between ligament and medial orbital wall does not have to be changed.