Long-term follow-up of one-piece fronto-orbital advancement with distraction but without a bandeau for coronal craniosynostosis: Review of 26 consecutive cases.

Abstract

To adopt the traditional fronto-orbital advancement technique designed by Tessier in the application of a distraction technique, the frontal bone flap should be detached before the distraction. In order to maximize the merit and potency of the distraction, we have applied the "one-piece cranioplasty" technique without bandeau for coronal craniosynostosis. Our new surgical technique was used to treat 10 unilateral and 16 bilateral craniosynosis patients between February 2005 and August 2014. Satisfactory results were achieved in all patients. An average distraction of 25.2mm was possible without detachment from the dura mater. The average cephalic index (width/length×100) decreased from 98.3 to 89.9 after 3 months postoperatively and was maintained at 88.6 until 6.4 years on average after the operation. In 10 unilateral coronal synostotic patients, the endocranial angulation of the anteroposterior axis was improved from 165.3° to 174.8° after 3 months postoperatively and was maintained at 174.5° until 5.8 years on average after the operation. Our present findings indicate that the novel one-piece fronto-orbital advancement with distraction approach appears to be less invasive and is suitable for correcting single-suture coronal craniosynostoses, except for the complex form of this condition, even at longer follow-up intervals.