Download - 03 traumatic telecanthus
![Page 1: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/1.jpg)
All about traumatic telecanthus. Is perfection possible?
M. Ibrahim KhanFRCSI, FCPS (Plastic Surgery)
Department of Plastic SurgeryPakistan Institute of Medical Sciences
Islamabad
![Page 2: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/2.jpg)
Anatomy
![Page 3: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/3.jpg)
Anatomy
![Page 4: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/4.jpg)
Nasoethmoidal-orbital fractures- Types I & II
![Page 5: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/5.jpg)
Types III & IV
![Page 6: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/6.jpg)
Clinical exam
Telecanthus Swelling Nasal deformity Instability- bimanual exam Other fractures CSF leak Lacrimal drainage
![Page 7: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/7.jpg)
Radiographic exam
Fractures isolating central fragment:
1. Frontal process-frontal bone junction2. Medial orbital fractures3. Inferior orbital rim fractures4. Nasal fractures
![Page 8: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/8.jpg)
Treatment
No role for closed treatment
Canthal ligament attached to bone?
![Page 9: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/9.jpg)
Problems
Getting it there
Keeping it there
![Page 10: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/10.jpg)
Exposure
Bicoronal Lower eyelid Gingival buccal
sulcus Laceration Nasal incision
![Page 11: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/11.jpg)
Other important steps
Adequate dissection & release Scar excision Reduction Trans-nasal wiring Fixation of fractures Ancillary procedures Canthal reattachment Soft tissue reapproximation
![Page 12: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/12.jpg)
Trans-nasal wiring
![Page 13: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/13.jpg)
Canthal reattachment
![Page 14: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/14.jpg)
Fracture fixation
![Page 15: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/15.jpg)
Summary
Early detection & intervention Good exposure Adequate release Correct vector of pull Soft tissue approximation to bone Correction of nasal deformity Has to look right on the table
![Page 16: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/16.jpg)
Conclusion
Pleasing outcome is a realistic aim
![Page 17: 03 traumatic telecanthus](https://reader036.vdocument.in/reader036/viewer/2022062900/58d0df561a28ab47238b6f91/html5/thumbnails/17.jpg)
Thank you!