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Non-syndromic trigonocephaly: surgical decision making and long-term cosmetic results.

AbstractBACKGROUND:
Surgical correction is often required for cosmetic correction of trigonocephaly. The purpose of this paper was to report the long-term aesthetic outcome as appreciated by the parents/patients themselves. The self-evaluation of cosmetic outcome after trigonocephaly correction has not previously been reported. The management and different surgical techniques utilized over a 16-year period are discussed.
MATERIALS AND METHODS:
An observational study was undertaken of the clinical outcome, operative data, complications and cosmetic satisfaction of these trigonocephaly patients. The parents/child were asked to rate their satisfaction with the cosmetic outcome both in terms of head shape and scar appearance, on a five-point scale (excellent-5, very good-4, good-3, fair-2 and poor-1).
RESULTS:
Sixty-three patients presented with non-syndromic trigonocephaly over the 16 years. Nineteen of 63 had a mild form of trigonocephaly and were managed conservatively. The remainder underwent surgical correction. Forty-two of 44 (95%) underwent fronto-orbital advancement with either barrel staving (26/44) or frontal bone rotation/re-modelling (16/44), with 2 of 44 having burring of the metopic ridge. Head shape rating was regarded as excellent in 25 of 63 (40%), very good in 18 of 63 (28%), good in 18 of 63 (28%) and fair in 2 of 63 (4%). Of those that underwent surgery, the scar was zigzag in 32 of 44 and straight in 12 of 44. Scar was rated as being excellent in 21 of 44 (48%), very good in 12 of 44 (28%) good in 11 of 44 (24%).
CONCLUSIONS:
Metopic synostosis can result in varying degrees of severity. Milder forms can be treated conservatively, with more severe forms requiring both frontal bone re-modelling and fronto-orbital advancement. Surgical correction results in a high level of patient/parent satisfaction.
AuthorsMichael O Kelleher, Dylan J Murray, Anne McGillivary, Mahmoud H Kamel, David Allcutt, Michael J Earley
JournalChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery (Childs Nerv Syst) Vol. 23 Issue 11 Pg. 1285-9 (Nov 2007) ISSN: 0256-7040 [Print] Germany
PMID17569057 (Publication Type: Journal Article)
Topics
  • Child
  • Child, Preschool
  • Cranial Sutures (abnormalities, surgery)
  • Craniosynostoses (surgery)
  • Esthetics
  • Female
  • Humans
  • Infant
  • Male
  • Orthopedic Procedures (methods)
  • Patient Satisfaction
  • Retrospective Studies
  • Severity of Illness Index
  • Skull (surgery)
  • Treatment Outcome

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