TY - JOUR T1 - Comparing two fronto-orbital advancement strategies to treat trigonocephaly in metopic synostosis. AU - Metzler,Philipp, AU - Ezaldein,Harib H, AU - Persing,John A, AU - Steinbacher,Derek M, Y1 - 2014/04/26/ PY - 2014/03/02/received PY - 2014/04/11/revised PY - 2014/04/15/accepted PY - 2014/7/7/entrez PY - 2014/7/7/pubmed PY - 2015/12/15/medline KW - Fronto-orbital advancement KW - Metopic KW - Metopic synostosis KW - Suture KW - Tilt procedure KW - Trigonocephaly SP - 1437 EP - 41 JF - Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery JO - J Craniomaxillofac Surg VL - 42 IS - 7 N2 - BACKGROUND: Trigonocephalic treatment entails frontoorbital reshaping of the forehead, increasing bitemporal dimensions, and advancing lateral orbits. Various techniques can achieve this, but no consensus exists regarding effects on long-term skull growth. Overcorrecting forehead dimensions is one strategy though preserving a vascularized fronto-orbital bar can influence future growth. We therefore seek to craniomorphologically compare fronto-orbital advancement (FOA), using bandeau widening and advancement, to a pedicled "tilt" procedure to assess whether adequate 3D remodeling is achieved. METHODS: Demographic and computed tomographic data was recorded. Pre- and post-craniometric measurements were performed for the endocranial bifrontal angle, orbital plane angle, anterior advancement and the interzygomaticofrontal suture distance. RESULTS: 40 CT scans were analyzed, with similar demographics. No perioperative complications were encountered. The endocranial bifrontal angle increased in the FOA (p = 0.00026) and tilt groups (p = 0.00297), along with the orbital plane angles (FOA, p = 0.020498; tilt, p = 0.07371), the anterior advancement (FOA, p = 0.00932; tilt, p = 0.05823), and the interzygomaticofrontal suture distance (FOA, p = 0.001241; tilt, p = 0.07811). CONCLUSIONS: Both techniques improve frontoorbital dimensions for correction of metopic synostosis. In severe trigonocephaly phenotypes, the FOA allows a greater magnitude of expansion and overcorrection, but compromises preservation of a vascularized leash. The "tilt" procedure possesses the benefit of near-anatomic bandeau remodeling, while potentially improving long-term growth. SN - 1878-4119 UR - https://www.unboundmedicine.com/medline/citation/24997751/Comparing_two_fronto_orbital_advancement_strategies_to_treat_trigonocephaly_in_metopic_synostosis_ DB - PRIME DP - Unbound Medicine ER -