Related Experiment Video
Updated: Jan 8, 2026
Author Spotlight: A Reproducible and Efficient Method for Accessing Porcine Brain via Craniectomy
Published on: July 5, 2024
Craniofacial Symmetry Progression following Strip Craniectomy in Unilateral Coronal Craniosynostosis
Lucas M Harrison1, Rami R Hallac1, Paymon Sanati-Mehrizy1
1From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
Background:
Strip craniectomy in unilateral coronal craniosynostosis (UCS) is associated with shorter operations, fewer complications, reduced transfusions, fewer ophthalmic disorders, and improved craniofacial morphology. However, the tempo and extent of changes in craniofacial features after surgery are less well understood. The purpose of this study is to evaluate the progression of craniofacial symmetry over time after strip craniectomy in UCS.
Methods:
Eighteen patients with UCS were evaluated before surgery and at 3 months, 6 months, 1 year, and 2 years after strip craniectomy with helmet therapy. Three-dimensional images were used to assess craniofacial asymmetries. Craniofacial composites were created. Eighteen control patients were included for comparison.
Results:
Before surgery, brow projection asymmetry (92.51% ± 4.23%; P < 0.001), orbital width (89.26% ± 6.57%; P = 0.003) and height asymmetry (118.42% ± 7.79%; P = 0.043), and midface asymmetry (91.42% ± 3.14%; P < 0.001) were significantly different between sides. Cranial asymmetry (91.97% ± 4.36%), decreased height of the ipsilateral orbit (6.50 ± 1.09 degrees), contralateral forehead bossing (10.51 ± 1.64 degrees), and nasal and chin deviation to the contralateral side (7.90 ± 2.30 degrees and 5.86 ± 1.48 degrees, respectively) were present. By 3 months after surgery, all craniofacial measurements had significantly improved from their preoperative values ( P < 0.050). Cranial asymmetry (98.73% ± 2.02%), frontal bossing (1.28 ± 0.27 degrees), brow projection asymmetry (98.34% ± 1.27%), orbital height (102.47% ± 8.40%) and vertical asymmetry (0.84 ± 0.46 degrees), and nasal and chin deviation (1.60 ± 0.89 degrees and 1.17 ± 0.59 degrees, respectively) were not significantly different from controls at 2 years. Orbital width and midface asymmetry remained significantly different from controls.
Conclusions:
Patients with UCS demonstrated significant asymmetry before surgery that significantly improved by 3 months after surgery. Most craniofacial features normalized compared with controls by 2 years after surgery, except for orbital width and midface asymmetry.
Related Concept Videos
01:22Sutures of the Skull
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
01:14Cranial Bones: Superior and Posterior View
The frontal bone is the single bone that forms the forehead. At its anterior midline, between the eyebrows, there is a slight depression called the glabella. The frontal bone also forms the supraorbital margin of the orbit. Near the middle of this margin is the supraorbital foramen, the opening that provides passage for a sensory nerve to the forehead. The frontal bone is thickened just above each supraorbital margin,...
01:27Cranial Bones: Lateral View
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...
01:08Overview of the Skull
The cranial vault surrounds and protects the brain and houses the middle and inner ear structures. This cavity is bounded superiorly by the rounded top of the skull, which...