Gradual distraction fronto-orbital advancement with 'floating forehead' for patients with syndromic craniosynostosis

Eleven patients with syndromic craniosynostosis were treated with gradual distraction fronto-orbital advancement using "floating forehead." The frontal and supraorbital area was cut and remolded. Bony orbits were widened in three patients. Frontal bone was let floating on the dura and fixed loosely with absorbable threads to remolded supraorbital bone. A pair of distracters with hinge plates (A.V.D. system, Bear Medic Corp, Tokyo, Japan) was fixed between the temporal area and supraorbital bone. Distraction was begun 5 to 7 days after the surgery, and 1.8 to 3.2 cm advancement was obtained. Distracters were taken off after 3 to 7 weeks of consolidation periods. Although no major complication was encountered, some minor complications related to the devices were experienced.