Related Experiment Videos
Surgical correction of trigonocephaly: theoretical basis and operative procedures
1Department of Neurosurgery, Fukuyama National Hospital, Hiroshima.
Insights
Surgical correction of trigonocephaly using metopic suture opening and cranial base expansion offers excellent results. Optimal surgical timing for trigonocephaly is 3-6 months for best outcomes.
Area of Science:
- Craniofacial surgery
- Pediatric neurosurgery
- Plastic surgery
Background:
- Trigonocephaly is a condition characterized by premature fusion of the metopic suture and skull base sutures.
- This fusion can lead to abnormal head shape and potential midface hypoplasia, including hypotelorism.
Purpose of the Study:
- To evaluate the efficacy of surgical treatment for trigonocephaly.
- To assess the outcomes of metopic suture release and anterior cranial base expansion.
- To determine the optimal age for surgical intervention.
Main Methods:
- Surgical intervention involved opening the fused metopic suture and expanding the anterior cranial base with "neosutures".
- Procedures included lateral canthal advancement and forehead remodeling.
- Three pediatric patients with trigonocephaly were treated.
Main Results:
- Excellent cosmetic results were achieved with the combined surgical approach.
- The procedures effectively prevented midface hypoplasia and hypotelorism.
- Younger patients (0-6 months) showed rapid bone regeneration and normalization of intercanthal/interpupillary distances.
- An older patient (8 years) had persistent skull defects.
Conclusions:
- Surgical correction of trigonocephaly is effective, yielding excellent cosmetic and functional outcomes.
- The optimal age for surgery is between 3 and 6 months.
- Early intervention minimizes visual repercussions and perioperative risks, leading to better bone growth and normalization of facial features.
Abstract:
Trigonocephaly involves premature fusion of both the metopic suture and the sutures in the skull base. Surgical treatment by opening of the prematurely fused metopic suture and expansion of the anterior cranial base by creating "neosutures" was used to treat three children with trigonocephaly. The combination of lateral canthal advancement and radical forehead remodeling achieved excellent results. These procedures can also prevent the development of midface hypoplasia such as hypotelorism. The two younger patients, aged 0 and 6 months, achieved rapid bone growth in the defects and normalization of intercanthal and interpupillary distances. The older patient, aged 8 years, retained some skull defects at follow-up. The optimal age for surgery is 3-6 months, which allows good cosmetic results and minimizes visual repercussions with relatively low perioperative risks.