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New objective measurement of forehead symmetry in unicoronal craniosynostosis - comparison between fronto-orbital advancement and forehead remodelling with a bone graft.

Artikel i vetenskaplig tidskrift
Författare Giovanni Maltese
Peter Tarnow
Annelie Lindström
Jakob Heydorn Lagerlöf
Peter Bernhardt
Robert Tovetjärn
Lars Kölby
Publicerad i Journal of plastic surgery and hand surgery
Volym 48
Nummer/häfte 1
Sidor 59-62
ISSN 2000-6764
Publiceringsår 2014
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för radiofysik
Institutionen för kliniska vetenskaper, Avdelningen för plastikkirurgi
Sidor 59-62
Språk en
Länkar dx.doi.org/10.3109/2000656X.2013.81...
Ämnesord Unicoronal synostosis, craniosynostosis, forehead symmetry, bone graft
Ämneskategorier Plastikkirurgi, Kirurgi

Sammanfattning

Abstract Patients with unicoronal synostosis (UCS) present with ipsilateral forehead flattening, contralateral frontal bossing, and rotation of the facial midline. Uni- or bilateral fronto-orbital advancement (FOA) techniques are the most common surgical approaches for correction of UCS. The purpose of this study was to objectively evaluate the surgical outcome in patients for UCS, using a new MATLAB computer tool programmed to measure the symmetry of the two halves of the forehead.Files were reviewed from a consecutive series of patients treated for UCS at the unit, from 1979-2008. The patients were grouped according to the method of operation used. The computer tool evaluated preoperative and postoperative cephalograms and CT scans. Eighty-eight patients were included. The male-to-female ratio was 1:2.4. Forty-six patients had been operated on with FOA and 42 with forehead remodelling using a calvarial bone graft. Forehead symmetry was significantly improved by both techniques (p < 0.001 for both), but the postoperative forehead symmetry was significantly better after forehead remodelling (p = 0.025). The reoperation rate was much lower for the second group (6.5 vs 37.2%, p < 0.001). It is concluded that forehead remodelling with a calvarial bone graft creates a more symmetrical forehead than FOA and may, therefore, be a better alternative for treatment of unicoronal synostosis.

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