Frontoorbital advancement in coronal suture craniosynostosis: a quantitative preoperative assessment

Abstract

Background Surgical therapy of coronal craniosynostosis in the modern era has evolved with the adoption of frontoorbital advancement and forehead reshaping to correct the supraorbital rim recession and the abnormal form of the cranium. The aim of this study was to evaluate the efficiency of quantitative preoperative planning for the degree of frontoorbital advancement in treatment of coronal craniosynostosis.
Patients and methods Fourteen patients (eight bilateral and six unilateral cases) who presented with simple nonsyndromic coronal craniosynostosis were treated surgically at the Plastic Surgery Unit in Zagazig University Hospital. The degree of the needed frontoorbital advancement was determined preoperatively using longitudinal orbital projection. Standard surgical correction was performed in all cases including frontoorbital advancement and forehead reshaping. Follow-up was based on clinical examination, computed tomography, and longitudinal orbital projection.
Results The preoperative and postoperative longitudinal orbital projection documented significant improvement in the relationship between the supraorbital rim and the cornea in all cases, with normalization of the relationship between the supraorbital rim and the cornea in eight patients (five patients were bilateral, and three patients were unilateral).
Conclusion Frontoorbital advancement and forehead reshaping for treatment of bilateral and unilateral coronal craniosynostosis achieve excellent functional and aesthetic results. Quantitative preoperative planning to determine the degree of frontoorbital advancement is highly recommended to achieve significant improvement and normalization of the relationship between the supraorbital rim and the cornea.

Keywords: coronal craniosynostosis, frontoorbital advancement, forehead reshaping