Fronto-orbital advancement and reconstruction using reverse frontal bone graft without the use of orbital bar: a technical note

Robins, James M.; Sheikh, Asim; Shastin, Dmitri; Schramm, Moritz; Carter, Paula; Russell, John L.; Liddington, Mark; Chumas, Paul

doi:10.1007/s00381-020-04583-w

Cited by 1 publication

(1 citation statement)

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“…29 It does not include a deliberate degree of overcorrection 28 aimed at reducing any subsequent deformity and it differs from the classical bandeau-preserving procedure of Marchac and Renier 30 by sacrificing the SOR. The similarities between the timing and physical characteristics of the indentations (‘‘hollowing’’) seen in this and other series 1,15 suggest, however, that its origins lie neither in variations of surgical technique (bandeau versus nonbandeau 31 for example) nor between different bandeau-preserving procedures. 1…”

Section: Discussionsupporting

confidence: 47%

Late Deformity Following Fronto-Orbital Reconstructive Surgery for Metopic Synostosis: The Role of Temporalis Muscle

James

Rossi‐Espagnet

Moltoni

et al. 2022

Journal of Craniofacial Surgery

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: Theories for late-developing deformity (LDD) following fronto-orbital reconstructive surgery (FOR) for metopic synostosis (MS) must explain both its delayed onset and its physical characteristics. This study examined whether FOR-related interference with the normal childhood expansion of temporalis is responsible for its soft tissue component. Three-dimensional reformats of preoperative and postoperative computed tomography scans of MS patients were reviewed. Measurements of vertical and horizontal reach of temporalis against those of the underlying skull (to allow for normal skull growth) were compared with normal subjects. The thickness of temporalis and the development of the temporal crests were also assessed. Mean age at FOR was 17.1 months; interval between surgery and first report of LDD 4.7 years; mean age at computed tomography scan for post-FOR LDD patients 8.8 years. There was a significant difference between vertical and horizontal reach of temporalis in pre-FOR MS patients compared to normal subjects (P < 0.0017 and P < 0.05, respectively). The vertical age-related reach of temporalis in post-FOR patients after allowing for underlying skull growth was significantly reduced (P = 0.0045) compared to normal subjects but not its horizontal reach (P = 0.25). Temporal crests in LDD patients were absent or aberrantly formed while muscle thickness was similar to normal subjects at the 2 levels measured. This study supports the theory that failure of the normal childhood expansion of temporalis is responsible for the soft tissue element of LDD, accounting for both its delayed onset and physical characteristics. Aberrant temporal crest development suggests FOR-related damage as the probable cause.

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