Orbital dystopia managed with unilateral brow suspension

Patients with orbital dystopia present with symptoms of diplopia and/or facial asymmetry. Repositioning of the orbit requires multiple osteotomies around the orbit, which presents significant complications. The authors present an alternative method to restore facial symmetry in the case of a 14-year-old patient with congenital orbital dystopia due to fibrosis of the sternocleidomastoid muscle. The patient had no ocular symptoms but did have asymmetric descent of the ipsilateral brow. He refused box osteotomy and repositioning of the orbit. Unilateral brow suspension was performed using an endoscopic technique and suspension sutures fixed to resorbable screws. Adequate brow elevation was noted in the immediate postoperative period and at 6 months; it successfully restored facial symmetry.