Trigonocephaly: refinements in reconstruction. Experience with 33 patients

Area of Science:

• Craniofacial Surgery
• Pediatric Neurosurgery
• Plastic Surgery

Background:

• Metopic synostosis is a premature fusion of the metopic suture, leading to characteristic forehead deformities.
• Traditional surgical approaches for metopic synostosis have varying degrees of success and potential complications.
• An interdisciplinary team approach is crucial for managing complex craniofacial anomalies.

Purpose of the Study:

• To evaluate the efficacy and safety of a modified craniofacial reconstruction technique for metopic synostosis.
• To analyze the cosmetic and functional outcomes of the surgical modifications.
• To compare the results with previous surgical methods for metopic synostosis.

Main Methods:

• Retrospective review of 33 consecutive patients with metopic synostosis treated between 1980 and 1984.
• Craniofacial reconstruction involving detailed remodeling of supraorbital rims and forehead by an interdisciplinary team.
• Analysis of cosmetic results, reoperation rates, and functional outcomes (visual, cerebral).

Main Results:

• Superior cosmetic results were achieved compared to previous methods.
• A low reoperation rate of less than 10% was observed, primarily in complex cases.
• No deaths, infections, or damage to visual or cerebral function were reported.
• Postoperative head circumference showed an initial increase followed by normal growth.

Conclusions:

• The modified craniofacial reconstruction technique offers significant advantages in safety and reproducibility for metopic synostosis.
• The technique yields superior cosmetic outcomes and preserves neurological and visual function.
• This approach represents an advancement in the surgical management of metopic synostosis.