Relapse in Fronto-Orbital Advancement

Abstract

Our unit policy in fronto-orbital advancement (FOA) and remodeling has been initial overcorrection to improve the ultimate aesthetic outcome of surgery. To assess relapse of anteroposterior (AP) correction in patients with cranial synostosis undergoing FOA and remodeling, a retrospective pilot study identified patients from the unit database. Serial AP calvarial measurements were used to record surgical and postsurgical changes. Patients showing a change in measurements toward preoperative values were considered to have relapsed. Associated factors were recorded, and statistical analysis was carried out using SPSS.Thirty-one patients (female n = 10, male n = 21) with a median age at surgery of 17 months and a mean weight of 11 kg were included in the study. The mean hospital stay was 7 days. The mean advancement was 13 (SD, 4) mm, and relapse occurred in 65% (20/31). Mean AP relapse at 5 months was 6.2 mm. No patient required subsequent FOA. No significant correlation was found between relapse and age, weight, hospital stay, and syndromic status. Anteroposterior relapse of the fronto-orbital segment occurred in two thirds (65%) of our cohort at 5 months. A prospective study is now under way to analyze this further. The results of this pilot study suggest that strategies to minimize or to compensate for relapse may enhance the ultimate surgical result.

An Evaluation of Complications, Revisions, and Long-Term Aesthetic Outcomes in Nonsyndromic Metopic Craniosynostosis

“…Indeed, different authors have cited a wide range of complication, reoperation, and recurrence rates. [8][9][10][11][12][13][14] The purpose of this study was to evaluate the complications, revisions, and long-term aesthetic outcomes of patients with isolated metopic synostosis at a single institution.…”

Assessing aesthetic outcomes after trigonocephaly correction

“…Lwin et al reported the relapse of fronto-orbital advancement in an anterior-posterior direction within 5 months postoperatively in 65 % of the analysed patients [23]. In the trigonocephaly group, they reported an operative advancement loss of up to 57 %, which seems very high.…”

Cranial distraction osteogenesis for syndromic craniosynostosis: Long-term follow-up and effect on postoperative cranial growth

“…11 Therefore, to solve these problems, the cranial volume should be overcorrected to compensate for postoperative growth suppression to gain enough enlargement at the surgery. 3,12,13 Our distraction approach was 75 mm between the dorsum sellae and the frontal bone on the orbitomeatal plane. 7 This single parametrical criterion is simple and useful for predicting the degree of enlargement of the anterior cranial vault; however, it can be excessive and impractical in early infancy.…”