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Purpose <p>The purpose of this study is to define the perioperative outcomes and long-term aesthetic outcomes of patients with unicoronal craniosynostosis (UCS) treated with fronto-orbital distraction osteogenesis (FODO) and compare them to a contemporaneous cohort treated with conventional fronto-orbital advancement and remodeling (FOAR).</p> Methods <p>A retrospective review was performed for all patients treated at the Children’s Hospital of Philadelphia for non-syndromic UCS from 2009–2025. Demographic and perioperative data were collected. Preoperative and 5-year or greater postoperative frontal 2D photographs were used to assess for facial, and specifically periorbital, symmetry. Symmetry ratios were calculated to assess periorbital facial morphometry.</p> Results <p>Sixty-two patients were included in the study, 34 FODO, and 28 FOAR. FODO demonstrated significantly shorter anesthesia and surgical times, lower estimated blood loss, and shorter length of stay (all <i>p</i> &lt; 0.001). The overall complication rate was similar (<i>p</i> = 0.175), but postoperative infection was more commonly reported in the FODO group (24 vs 1%, <i>p</i> = 0.033). Thirty-two patients had a 5-year or greater postoperative photographs, 16 FODO, and 16 FOAR. Patients in the FODO group were found to have greater improvements in palpebral width symmetry (0.32 vs -3.4, <i>p</i> = 0.039) and canthal tilt symmetry (1.51 vs -1.20 degrees, <i>p</i> = 0.035). One patient in the FOAR group required reoperation due to signs of elevated ICP.</p> Conclusion <p>FODO results in improved perioperative and long-term aesthetic outcomes compared to FOAR, resulting in improved canthal tilt and palpebral width symmetry. Future studies should focus on severity-matched analyses.</p>

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Distraction in anterior plagiocephaly: technique, risks, and long-term results

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • Santiago Lopez-Becerra,
  • David Perrault,
  • Kirin Naidu,
  • Maura R. Guyler,
  • Samir Shakir,
  • Jordan W. Swanson,
  • Jesse A. Taylor

摘要

Purpose

The purpose of this study is to define the perioperative outcomes and long-term aesthetic outcomes of patients with unicoronal craniosynostosis (UCS) treated with fronto-orbital distraction osteogenesis (FODO) and compare them to a contemporaneous cohort treated with conventional fronto-orbital advancement and remodeling (FOAR).

Methods

A retrospective review was performed for all patients treated at the Children’s Hospital of Philadelphia for non-syndromic UCS from 2009–2025. Demographic and perioperative data were collected. Preoperative and 5-year or greater postoperative frontal 2D photographs were used to assess for facial, and specifically periorbital, symmetry. Symmetry ratios were calculated to assess periorbital facial morphometry.

Results

Sixty-two patients were included in the study, 34 FODO, and 28 FOAR. FODO demonstrated significantly shorter anesthesia and surgical times, lower estimated blood loss, and shorter length of stay (all p < 0.001). The overall complication rate was similar (p = 0.175), but postoperative infection was more commonly reported in the FODO group (24 vs 1%, p = 0.033). Thirty-two patients had a 5-year or greater postoperative photographs, 16 FODO, and 16 FOAR. Patients in the FODO group were found to have greater improvements in palpebral width symmetry (0.32 vs -3.4, p = 0.039) and canthal tilt symmetry (1.51 vs -1.20 degrees, p = 0.035). One patient in the FOAR group required reoperation due to signs of elevated ICP.

Conclusion

FODO results in improved perioperative and long-term aesthetic outcomes compared to FOAR, resulting in improved canthal tilt and palpebral width symmetry. Future studies should focus on severity-matched analyses.