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Ocular abnormalities associated with unilateral coronal synostosis

J M Pensler1, S M Balich, M J Greenwald

  • 1Division of Plastic Surgery, Children's Memorial Hospital, Chicago, IL 60614.

Annals of Plastic Surgery
|August 1, 1994
PubMed
Summary
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Premature fusion of unilateral coronal sutures impacts eye muscle function. Craniofacial surgery may alter ophthalmological status, suggesting delayed extraocular muscle surgery is advisable.

Area of Science:

  • Craniofacial Surgery
  • Ophthalmology
  • Pediatric Plastic Surgery

Background:

  • Premature fusion of a unilateral coronal suture, a form of craniosynostosis, can lead to craniofacial deformities.
  • Extraocular muscle dysfunction is a known complication associated with craniosynostosis.

Purpose of the Study:

  • To evaluate the ophthalmological status of patients with unilateral coronal synostosis before and after craniofacial repair.
  • To determine the impact of craniofacial surgery on ocular alignment and function in this patient population.

Main Methods:

  • Retrospective review of 45 patients treated for unilateral coronal synostosis between 1985 and 1991.
  • Detailed pre- and postoperative assessment including photographs, CT scans, serial radiographs, and ophthalmological evaluations for 33 patients.

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Main Results:

  • 52% of patients had preoperative extraocular muscle function disorders.
  • Postoperatively, 21% showed a distinct change in ocular examination, and 72% presented with an abnormal ophthalmological examination.
  • A significant percentage experienced changes in ophthalmological status following craniofacial surgery.

Conclusions:

  • Patients with premature unilateral coronal suture fusion frequently exhibit postoperative ophthalmological abnormalities.
  • Extraocular muscle surgery should generally be deferred until after bony repositioning in craniofacial repair for unilateral coronal synostosis.