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Frontobasal suture distraction corrects hypotelorism in metopic synostosis.
J Craniofac Surg. 2009 Jan; 20(1):121-4.JC

Abstract

BACKGROUND

Spring-assisted cranioplasty has been demonstrated to correct hypotelorism associated with metopic synostosis. In addition, the fronto-orbital axis rotates toward a more normal orientation. We postulated that spring-induced shear forces and subsequent displacement across the frontobasal sutures are the primary initial mechanisms for change in cranio-orbital morphology.

METHODS

Sixteen consecutive patients (32 orbits) with trigonocephaly operated on between 1999 and 2004 were studied retrospectively. After frontal remodeling, a spring was placed across the released metopic suture. Preoperative and 6-week postoperative cephalograms were used to measure the relative translation of the medial orbital wall from the midline at fixed vertical distances above and below the frontoethmoidal suture (FES). The vertical height of the spring above the frontonasal suture and the patient's age were analyzed with respect to the increase in bony interorbital distance (BIOD).

RESULTS

There were significant increases in movement of the medial orbital wall above the FES at each measurement point (P < 0.001). There was no significant postoperative movement of the medial orbital wall below the FES at any measurement point. The relative movements above the suture suggest a degree of plastic deformation adjacent to the suture.There was no significant correlation between the age of patient or the height of the spring above the frontonasal suture and the increase in BIOD.

CONCLUSION

Tensile spring forces are transmitted directly to the frontoethmoid suture. Most initial increases in BIOD and altered intraorbital morphology are due to distraction of cranial base sutures rather than plastic deformation.

Authors+Show Affiliations

Central and Southern New Zealand Craniofacial Program, Wellington, New Zealand. info@craniofacialsurgery.co.nzNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19165007

Citation

Davis, Charles, and Claes G K. Lauritzen. "Frontobasal Suture Distraction Corrects Hypotelorism in Metopic Synostosis." The Journal of Craniofacial Surgery, vol. 20, no. 1, 2009, pp. 121-4.
Davis C, Lauritzen CG. Frontobasal suture distraction corrects hypotelorism in metopic synostosis. J Craniofac Surg. 2009;20(1):121-4.
Davis, C., & Lauritzen, C. G. (2009). Frontobasal suture distraction corrects hypotelorism in metopic synostosis. The Journal of Craniofacial Surgery, 20(1), 121-4. https://doi.org/10.1097/SCS.0b013e318190e25d
Davis C, Lauritzen CG. Frontobasal Suture Distraction Corrects Hypotelorism in Metopic Synostosis. J Craniofac Surg. 2009;20(1):121-4. PubMed PMID: 19165007.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frontobasal suture distraction corrects hypotelorism in metopic synostosis. AU - Davis,Charles, AU - Lauritzen,Claes G K, PY - 2009/1/24/entrez PY - 2009/1/24/pubmed PY - 2009/5/8/medline SP - 121 EP - 4 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 20 IS - 1 N2 - BACKGROUND: Spring-assisted cranioplasty has been demonstrated to correct hypotelorism associated with metopic synostosis. In addition, the fronto-orbital axis rotates toward a more normal orientation. We postulated that spring-induced shear forces and subsequent displacement across the frontobasal sutures are the primary initial mechanisms for change in cranio-orbital morphology. METHODS: Sixteen consecutive patients (32 orbits) with trigonocephaly operated on between 1999 and 2004 were studied retrospectively. After frontal remodeling, a spring was placed across the released metopic suture. Preoperative and 6-week postoperative cephalograms were used to measure the relative translation of the medial orbital wall from the midline at fixed vertical distances above and below the frontoethmoidal suture (FES). The vertical height of the spring above the frontonasal suture and the patient's age were analyzed with respect to the increase in bony interorbital distance (BIOD). RESULTS: There were significant increases in movement of the medial orbital wall above the FES at each measurement point (P < 0.001). There was no significant postoperative movement of the medial orbital wall below the FES at any measurement point. The relative movements above the suture suggest a degree of plastic deformation adjacent to the suture.There was no significant correlation between the age of patient or the height of the spring above the frontonasal suture and the increase in BIOD. CONCLUSION: Tensile spring forces are transmitted directly to the frontoethmoid suture. Most initial increases in BIOD and altered intraorbital morphology are due to distraction of cranial base sutures rather than plastic deformation. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/19165007/Frontobasal_suture_distraction_corrects_hypotelorism_in_metopic_synostosis_ L2 - https://doi.org/10.1097/SCS.0b013e318190e25d DB - PRIME DP - Unbound Medicine ER -