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Evaluación de los resultados a largo plazo del avance fronto-orbital en la sinostosis metópica: perspectivas de la
Pauline A E Tio1, Irene M J Mathijssen1, Marie-Lise C van Veelen2
1Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
Background:
Current literature on long-term surgical outcomes in patients with metopic synostosis is highly heterogeneous, with inconsistent outcome measures and varying follow-up durations. As a result, there is a lack of reliable data on post-surgical outcomes in late adolescence. The primary objective of this study was to objectively evaluate the long-term outcomes at skeletal maturity following fronto-orbital advancement (FOA) in patients with metopic synostosis.
Methods:
All patients with isolated metopic synostosis who underwent FOA at Sophia Children's Hospital between 2003-2008 were included. Their data were retrospectively reviewed. Head shape analysis was performed on all available 3D images of patients with metopic synostosis at their last follow-up appointment. CranioRate was used to determine pre-operative severity.
Results:
The total cohort consists of 107 patients, who underwent FOA at the median age of 11 months [IQR 9-12]. Head shape analysis on available 3D images at the age of 17 years (n = 48) showed that patients exhibit notable differences in forehead shape compared to healthy controls, characterized by frontal retrusion and temporal depressions. At late adolescence, 3.7% of patients with metopic synostosis who underwent FOA opted for a secondary recontouring procedure using PMMA. No significant differences were observed in factors such as age at primary surgery, sex, and pre-operative severity between those who underwent secondary recontouring and those who did not.
Conclusion:
At the age of 17 years, patients with metopic synostosis following FOA have evident temporal depressions and frontal retrusion. Initial severity had a minimal effect on these deformities.
