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. 2021 Nov-Dec;32(8):2768-2770.
doi: 10.1097/SCS.0000000000007931.

Correction of Metopic Craniosynostosis Using Limited Incision Strip Craniectomy Versus Open Fronto-Orbital Reconstruction: An Assessment of Aesthetic Outcomes

Michal Benkler  1 , Rami R Hallac  1   2 , Emily L Geisler  1 , Alex A Kane  1   2
Affiliations

Correction of Metopic Craniosynostosis Using Limited Incision Strip Craniectomy Versus Open Fronto-Orbital Reconstruction: An Assessment of Aesthetic Outcomes

Michal Benkler et al. J Craniofac Surg. 2021 Nov-Dec.

Abstract

Background: Metopic craniosynostosis is traditionally repaired with fronto-orbital advancement (FOA) or, alternatively, limited short scar strip craniectomy (LSSSC) followed by helmet therapy. There is controversy among surgeons regarding resultant head shape outcomes between the 2 methods. This study aims to assess how surgeons perceive the postoperative aesthetic results of the 2 metopic craniosynostosis repair methods.

Methods: A retrospective analysis was performed on 13 (n = 6 LSSSC; n = 7 FOA) patients who presented for surgical correction of isolated metopic craniosynostosis via either LSSSC (followed by helmet therapy) or FOA. Clinical photographs at 1 year postop were shown to 10 craniofacial surgeons who rated the aesthetic outcomes on a Likert scale of 1 (poor) to 5 (excellent) and guessed which surgical method was performed.

Results: Mean age at the time of the procedure was younger in LSSSC than FOA (3.1 ± 1.0 versus 17.5 ± 8.5 months; P < 0.001). Mean blood loss was significantly lower with LSSSC versus FOA (202.0 ± 361.2 versus 371.43 ± 122.9 mL; P < 0.001), as was mean blood transfusion requirement (92.5 ± 49.9 versus 151.3 ± 51.2 mL; P < 0.001) and mean duration of the operation (3:06 ± 0:24 versus 7:53 ± 0:31 hours; P < 0.001). Mean surgeon scores of aesthetic outcomes were similar between groups: LSSSC, 3.27 ± 1.09; FOA, 3.51 ± 0.95 (P = 0.171). When asked to identify which procedure patients had received, only 63.8% of responses were correct.

Conclusions: Limited short scar strip craniectomy offers an important alternative to traditional open FOA and should be considered as an option for children diagnosed with metopic craniosynostosis.

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Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Proctor MR. Endoscopic craniosynostosis repair. Transl Pediatr 2014; 3:247–258.
    1. Jimenez DF, Barone CM, Cartwright CC, et al. Early management of craniosynostosis using endoscopic-assisted strip craniectomies and cranial orthotic molding therapy. Pediatrics 2002; 110:97–104.
    1. Jimenez DF, Barone CM. Early treatment of anterior calvarial craniosynostosis using endoscopic-assisted minimally invasive techniques. Childs Nerv Syst 2007; 23:1411–1419.
    1. Hinojosa J. Endoscopic-assisted treatment of trigonocephaly. Childs Nerv Syst 2012; 28:1381–1387.
    1. Gociman B, Agko M, Blagg R, et al. Endoscopic-assisted correction of metopic synostosis. J Craniofac Surg 2013; 24:763–768.