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Published on: August 11, 2015
Distraction in anterior plagiocephaly: technique, risks, and long-term results
Santiago Lopez-Becerra1,2, David Perrault1, Kirin Naidu1
1Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
Summary
Fronto-orbital distraction osteogenesis (FODO) offers better perioperative and aesthetic results for unicoronal craniosynostosis (UCS) than fronto-orbital advancement (FOAR). FODO improves facial symmetry, though infection rates were higher in the FODO group.
Area of Science:
- Craniofacial Surgery
- Pediatric Plastic Surgery
- Neurosurgery
Background:
- Unicoronal craniosynostosis (UCS) is a congenital condition requiring surgical correction.
- Traditional fronto-orbital advancement and remodeling (FOAR) is a common surgical approach.
- Fronto-orbital distraction osteogenesis (FODO) is an alternative technique with potential benefits.
Purpose of the Study:
- To compare perioperative and long-term aesthetic outcomes of FODO versus FOAR for UCS.
- To evaluate facial and periorbital symmetry after surgical correction.
- To identify differences in complication rates and surgical parameters between the two techniques.
Main Methods:
- Retrospective review of non-syndromic UCS patients treated between 2009-2025.
- Collection of demographic and perioperative data.
- Assessment of long-term aesthetic outcomes using 2D frontal photographs (≥5 years postoperatively) to calculate symmetry ratios.
Main Results:
- FODO group (34 patients) showed significantly shorter operative times, less blood loss, and shorter hospital stays compared to FOAR (28 patients).
- Overall complication rates were similar, but FODO had a higher incidence of postoperative infection (24% vs 1%).
- FODO demonstrated superior improvement in palpebral width symmetry and canthal tilt symmetry compared to FOAR.
Conclusions:
- FODO yields superior perioperative and long-term aesthetic outcomes for UCS compared to FOAR.
- Improved symmetry in canthal tilt and palpebral width favors FODO.
- Further research should involve severity-matched analyses to refine treatment comparisons.
