Aesthetic results of fronto-orbital correction in trigonocephaly

The aesthetic results of craniofacial surgery for trigonocephaly were evaluated by a panel assessment using a scoring system based on deformities typical for this type of craniosynostosis. In this retrospective study pre-and postoperative photographs of 45 patients were scored for items typical for trigonocephaly: shape of the forehead, hypotelorism, and temporal depression. Each item was quantified as normal or absent (0 points), a mild deformity (1 point) or a severe deformity (2 points). Preoperatively, the most obvious deformity was temporal depression and this remained to be the most obvious deformity after surgery. There was a good overall correction of the presenting deformities with a decline in the mean score preoperatively from 4.49-1.13 postoperatively. There was a significant weak correlation between pre- and postoperative score only for hypotelorism. This indicates that the severity of the initial disease is not a major contributor to the final surgical result. Furthermore, surgical outcome seemed to be stable over time and was not influenced by the timing of surgery when surgery was scheduled between the ages of 6-15 months. Early craniofacial correction for trigonocephaly results in a stable, acceptable aesthetic result on which the initial deformity has little effect. The most common associated craniofacial characteristics are well- to very well-corrected when surgery is performed within the first 6-15 months. Main focus of deformity on short and long term remains the temporal depression, and thus requires extra attention during surgery.