Retrospective evaluation of different designs of distraction osteogenesis in brachycephalic craniosynostosis

This retrospective study analyzed the surgical outcomes of three different treatment design groups for craniosynostosis using distraction osteogenesis (DO). Thirty-six patients who underwent frontal bone advancement between 2009 and 2020 were divided into three groups based on the design and distraction method of the anterior frontal flap (AFF) and posterior flap (PF): Group 1 - Advancement of AFF; Group 2 - Simultaneous advancement of AFF and PF; Group 3 - Separate advancement of AFF and PF with a mid-coronal bridge (MCB). All surgical designs showed significant improvement in cranial shape, with increased anterior-posterior length and bitemporal length and decreased cephalic index (CI). Group 1 exhibited the worst bitemporal widening and CI improvement, while Group 2 and 3 were more effective in correcting brachycephaly. This study underscores the importance of surgical design in shape correction for bicoronal craniosynostosis, highlighting the benefits of addressing both the posterior occipital region and anterior forehead-orbital complex.