Fronto-orbital advancement and total calvarial remodelling for craniosynostosis.

OBJECTIVE To describe the results of fronto-orbital advancement and remodelling for craniosynostosis in children. STUDY DESIGN Case series. PLACE AND DURATION OF STUDY Department of Plastic Surgery, Combined Military Hospital, Rawalpindi, from June 2009 to June 2012. METHODOLOGY All the patients with cranial suture synostosis operated were included in the study. Those patients who were lost to follow-up were excluded. Variables considered were age, gender, type of synostosis, intracranial pressure, and history of previous surgeries for the same problem. Outcome measures were studied in terms of improvement of skull measurements (anteroposterior and bicoronal), duration of surgery, hospital stay, blood transfusions, complications and parents satisfaction. RESULTS A total of 36 patients were included in the study. Male to female ratio was 3:1. The age ranged from 5 to 54 months. Thirty two patients presented with non-syndromic and four with syndromic craniosynostosis. Fronto orbital advancement and total calvarial remodelling was done in 26 and 10 patients respectively. There was improvement in the skull measurements and the parents were satisfied in all cases with the skull shape. Complications occurred in 11.1% including chest and wound infection and one death. CONCLUSION Fronto-orbital advancement and remodelling is an effective procedure for the correction of craniosynostosis, however, individual cases may require other procedures like total calvarial remodelling.