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Mohamed Hamed Abdel-Raheem, Muhammad Hassan Abdel-Aal, Alaa Nabil El-Sadek, Mohammad-Reda Ahmad, Mahmoud Abdel-Nabi Saeed
» doi: 10.53555/ecb/2023.12.Si13.223


Background: Fronto-orbital advancement (FOA) is the corrective procedure for coronal and metopic craniosynostosis. The goal of the FOA is to expand cranial volume allowing brain growth thus, improve aesthetic and functional outcome. Traditionally, the degree of advancement of the fronto-orbital complex in bilateral and unilateral coronal craniosynostoses is a qualitative method and depends usually on the surgeon’s experience. The aim of this study is to evaluate the efficiency of quantitative preoperative planning for the degree of fronto-orbital advancement in the treatment of bilateral and unilateral coronal and metopic craniosynostosis. Patient and methods Twelve patients (four metopic, five unilateral coronal and three bilateral coronal). The metopic and unilateral coronal cases are simple non syndromic craniosynostosis while, bilateral coronal cases are syndromic craniosynostosis. All cases treated surgically at plastic and reconstructive surgery department, Zagazig university hospitals. The degree of the needed fronto-orbital advancement was determined preoperatively using longitudinal orbital projection. Surgical correction was performed in all cases in the form of fronto-orbital advancement and forehead reshaping. Follow up based on clinical examination, computed tomography and longitudinal orbital projection. Results There was statistically significant improvement in the relationship between the supraorbital rim and the cornea in all cases, most of operated cases (metopic, unicoronal and bicoronal ) showed excellent results with no statistically difference between them. Conclusion the current study showed that fronto-orbital advancement and fore head reshaping showed satisfactory outcome in the treatment of craniosynostosis. Fronto-orbital advancement resulted in significant improvement in supraorbital projection regardless of craniosynostosis type. Quantitative preoperative planning is highly recommended to achieve significantly better results and normalization of the fronto-orbital complex.

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