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. 2021 Oct 1;32(7):2362-2365.
doi: 10.1097/SCS.0000000000007773.

A Cohort Study of Strabismus Rates Following Correction of the Unicoronal Craniosynostosis Deformity: Conventional Bilateral Fronto-Orbital Advancement Versus Fronto-Orbital Distraction Osteogenesis

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A Cohort Study of Strabismus Rates Following Correction of the Unicoronal Craniosynostosis Deformity: Conventional Bilateral Fronto-Orbital Advancement Versus Fronto-Orbital Distraction Osteogenesis

Ian C Hoppe et al. J Craniofac Surg. .

Abstract

Background: The purpose of this prospective study is to compare perioperative morbidity and strabismus rates between traditional fronto-orbital advancement reconstruction (FOAR) and fronto-orbital distraction osteogenesis (FODO) in unicoronal craniosynostosis (UCS).

Method: A consecutive group of 15 patients undergoing FODO for isolated UCS were compared to a contemporaneous group of 15 patients undergoing traditional FOAR for UCS. Patient age, operative time, blood loss, blood replacement, technical details of the surgery, length of stay, complications, and strabismus rates were documented and compared statistically using chi-square and Student t test with a significance value of 0.05.

Results: The 15 patients undergoing FODO were younger (6.3 and 9.8 months, P < 0.05), experienced less operative time for the initial procedure (111 versus 190 minutes, P < 0.01), less blood loss (26% versus 50% of total blood volume, P < 0.01), and less blood replacement (40% versus 60% of total blood volume, P < 0.05). One patient in the FODO group experienced a new-onset strabismus postoperatively compared with 5 in the FOAR group (P < 0.05). There were no complications requiring a return to the operating room in either group.

Conclusions: Fronto-orbital distraction osteogenesis for the treatment of isolated UCS is associated with a favorable perioperative morbidity profile and a decreased incidence of postoperative strabismus compared with traditional FOAR. These positive factors are tempered by the need for an additional procedure for removal of the device and lack of long-term outcomes data on the technique.

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Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Di Rocco C, Paternoster G, Caldarelli M, et al. Anterior plagiocephaly: epidemiology, clinical findings, diagnosis, and classification. A review Child's nervous system. Child's Nerv Syst 2012; 28:1413–1422.
    1. Samra F, Paliga JT, Tahiri Y, et al. The prevalence of strabismus in unilateral coronal synostosis. Childs Nerv Syst 2015; 31:589–596.
    1. Gencarelli JR, Murphy A, Samargandi OA, et al. Ophthalmologic outcomes following fronto-orbital advancement for unicoronal craniosynostosis. J Craniofac Surg 2016; 27:1629–1635.
    1. MacKinnon S, Proctor MR, Rogers GF, et al. Improving ophthalmic outcomes in children with unilateral coronal synostosis by treatment with endoscopic strip craniectomy and helmet therapy rather than fronto-orbital advancement. J AAPOS 2013; 17:259–265.
    1. Bartlett SP, Whitaker LA, Marchac D. The operative treatment of isolated craniofacial dysostosis (plagiocephaly): a comparison of the unilateral and bilateral techniques. Plast Reconstr Surg 1990; 85:677–683.