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Published on: June 20, 2018
Endoscopic-assisted correction of metopic synostosis
Barbu Gociman1, Mouchammed Agko, Ross Blagg
1Division of Plastic Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA. barbu.gociman@hsc.utah.edu
The Journal of Craniofacial Surgery
|May 30, 2013
Summary
Minimally invasive endoscopic-assisted strip craniectomy offers excellent aesthetic outcomes for metopic synostosis correction. This technique, combined with helmet molding, provides a cost-effective and safe alternative to open surgery, with objective measures confirming successful correction.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Metopic synostosis, premature fusion of the metopic suture, can lead to forehead deformities.
- Traditional open surgical correction is associated with significant morbidity and cost.
- Minimally invasive techniques are increasingly explored for craniofacial anomalies.
Purpose of the Study:
- To present a 6-year experience with endoscopic-assisted strip craniectomy for metopic synostosis.
- To introduce an objective method for quantifying frontal vault contour correction.
- To evaluate the safety, efficacy, and cost-effectiveness of the minimally invasive approach.
Main Methods:
- Retrospective review of 16 patients undergoing endoscopic-assisted strip craniectomy for nonsyndromic metopic synostosis.
- Postoperative cranial vault helmet molding was employed.
- Objective assessment using laser scanning and definition of the 'metopic angle' for deformity quantification.
Main Results:
- Mean operative time was 79 minutes with average blood loss of 82.8 mL; 18.7% required transfusion.
- No significant postoperative complications, with a mean hospitalization of 1.6 days.
- Excellent aesthetic results were achieved in all patients, with significant improvement in the metopic angle (104.9° to 114.9° at 1 year).
- Average cost was $12,400, significantly lower than the $33,000 for open procedures.
Conclusions:
- Endoscopic-assisted strip craniectomy is a safe and effective treatment for metopic synostosis.
- The technique yields excellent aesthetic outcomes and is more cost-effective than open surgery.
- The defined 'metopic angle' provides a reliable objective measure for assessing frontal vault deformity and surgical correction.
