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Surgical Hypercorrection of Trigonocephaly: Evaluation of Surgical Outcomes
- Source :
- The Journal of craniofacial surgery. 29(1)
- Publication Year :
- 2017
-
Abstract
- BACKGROUND A lasting correction of trigonocephaly is difficult to achieve, as a durable correction requires significant expansion to overcome galeal restriction and soft tissue recoil of the scalp. High rates of relapse have been reported throughout the literature. The specific aim of this study was to determine if the senior author's method of "hypercorrection" decreases relapse and the need for subsequent revisional surgery. METHODS Patients who underwent operative correction of metopic craniosynostosis between 1988 and 2011 were reviewed. All patients underwent the "hypercorrection" technique performed by the senior author. Hypercorrection consisted of a fronto-orbital advancement of 2.5 to 3.5 cm and a concomitant hyperexpansion of bitemporal projection. Split cranial bone grafting ensured adequate coverage of the significantly expanded cranial vault. Only patients who had at least 5 years of follow-up were included for review of outcomes. Relapse was defined as recurrence of bitemporal constriction or lateral orbital retrusion, requiring surgical correction. RESULTS Fifty-eight patients met criteria. Mean age at the time of surgery was 11 months. Mean follow-up was 9.0 years. During this time, 2 patients exhibited relapse requiring camouflage procedures. Cranial bone defects were found in 4 patients (7%), 3 of whom underwent cranial bone grafting, while 1 underwent methylmethacrylate placement at an outside institution. One patient underwent fat grafting for areas of soft tissue irregularity. No patients exhibited persistent sequelae of hypercorrection significant enough to require repeat fronto-orbital advancement. CONCLUSION Surgical hypercorrection of trigonocephaly seems to minimize relapse and the need for revision in long-term follow-up and is therefore an important technique to consider.
- Subjects :
- Male
Reoperation
medicine.medical_specialty
Trigonocephaly
Methylmethacrylate
03 medical and health sciences
Craniosynostoses
0302 clinical medicine
Recurrence
Cranial vault
medicine
Humans
Child
Retrospective Studies
Bone Transplantation
business.industry
Skull
Soft tissue
Infant
General Medicine
Surgical correction
Plastic Surgery Procedures
medicine.disease
Metopic craniosynostosis
Surgery
medicine.anatomical_structure
Treatment Outcome
Otorhinolaryngology
Adipose Tissue
Hypercorrection
030220 oncology & carcinogenesis
Concomitant
Scalp
Child, Preschool
Frontal Bone
Female
business
Orbit
030217 neurology & neurosurgery
Follow-Up Studies
Subjects
Details
- ISSN :
- 15363732
- Volume :
- 29
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- The Journal of craniofacial surgery
- Accession number :
- edsair.doi.dedup.....812c9f894e943c41ef14167ca3934cfb