Metopic craniosynostosis: Dynamic cranioplasty for trigonocephaly versus fronto-orbital remodeling and advancement — A retrospective study

• Published in: Journal of cranio-maxillo-facial surgery Vol. 52; no. 9; pp. 966 - 973
• Main Authors: Nunes Pombo, João, van Mourik Zoio, Marta, Santos, Maria Manuel, Faria, Cláudia C., Miguéns, José, Guimarães-Ferreira, José
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01-09-2024
• Subjects: Anthropometric outcome; Cephalometry; Child; Child, Preschool; Craniofacial surgery; Craniosynostoses - surgery; Craniotomy - methods; Female; Frontal Bone - abnormalities; Frontal Bone - surgery; Fronto-orbital advancement; Humans; Infant; Male; Metopic craniosynostosis; Orbit - surgery; Plastic Surgery Procedures - methods; Retrospective Studies; Treatment Outcome; Trigonocephaly; Anthropometric outcome; Metopic craniosynostosis; Trigonocephaly; Craniofacial surgery; Fronto-orbital advancement
• ISSN: 1010-5182; 1878-4119; 1878-4119
• DOI: 10.1016/j.jcms.2024.04.008

The aim of this study was to compare a traditional fronto-orbital remodeling and advancement (FORA) with the dynamic cranioplasty for trigonocephaly (DCT).
The authors analyzed patients who underwent surgery for trigonocephaly. Perioperative data were compared. Parents were asked to use a visual analog scale to evaluate the pre- and postoperative distance between the eyes, the forehead shape, and the global appearance of the face. A panel of observers was asked to grade pre- and postoperative photographs using a similar visual analog scale. Pre- and postoperative anthropometric data were collected and analyzed in a subset of the study population aged 9 years or older.
The total sample size was 51 patients (DCT n = 39; FORA n = 12). Durations of surgery and anesthesia were shorter in the DCT group (115 vs 194 min, p = 0.001; 226 vs 289 min, p = 0.001). Patients in the DCT group received similar preoperative ratings to those in the FORA group, but significantly higher postoperative ratings by parents for all three questions. There were no significant differences in postoperative ratings by the panel or postoperative anthropometric data.
DCT is safe and effective. It is preferred over FORA because it is associated with shorter durations of surgery and anesthesia, while providing higher degrees of parental satisfaction and similar aesthetic and anthropometric outcomes.