PMC4704399_01
The protruding recurred mass in the right eyelid and eyebrow with orbital dystopia. Right eye set 1 cm lower than the left (black line)
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Fig1
Four years later, in March 2014, he returned to our clinic complaining about the protruding recurred mass in the right eyelid and eyebrow with orbital dystopia (Fig. 1).
(Left) Pre-operative facial computer tomography of a 34-year-old man with orbitotemporal neurofibromatosis type 1. (Right) Post-operative facial computer tomography with L-shaped calvarial bone graft
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Fig2
The bone graft was designed into an L-shape to restore the lateral wall and floor of the widened orbit (Fig. 2).
Clinical photograph after mass removal and orbital remodeling. Both eyes are located almost at the same level (black line)
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Fig3
The right eyeball was elevated 1 cm upward by a calvarial bone graft in the orbit, resulting in both eyes being placed almost at the same level, restoring orbital symmetry (Fig. 3).
Clinical photograph of ptosis correction. A levator aponeurosis-Muller muscle composite flap can be seen
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Fig4
The Muller muscle and levator aponeurosis composite flap was elevated (Fig. 4) and fixed to the superior portion of the tarsal plate at three points.
The final post-operative clinical photograph 4 months after ptosis surgery. Dystopia and ptosis were corrected
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Fig5
The patient was satisfied with the symmetric orbit and ptosis correction (Fig. 5).