Cranial vault growth patterns of plagiocephaly and trigonocephaly patients following fronto-orbital advancement: a long-term anthropometric outcome assessment

Abstract

Fronto-orbital advancement (FOA) is the most common technique used to correct plagiocephaly and trigonocephaly. The aim of this study was to investigate the cranial vault growth following FOA and to compare the growth pattern to the normal standard. Fifty-two Swiss children (25 with anterior plagiocephaly and 27 with trigonocephaly) between the surgical ages of 8 and 10 months were included in this 5-year follow-up study. A standardised time protocol (before the procedure; 6 weeks and 6 months after the surgery; and then annually until the age of six) for anthropometric skull measurements (head circumference, cranial length, and breadth and cephalic indices) was used to analyse the pre- and post-operative cranial vault growth patterns. Data were converted into the Z-score for standardised inter-centre comparison. For all the patients, a significant improvement in the shape of the cranial vault following FOA was observed. In both the plagiocephaly and trigonocephaly groups, the long-term cranial growth patterns (head circumference and cranial length and breadth) significantly differed following this procedure in comparison to those of the control group. The cephalic indices remained constant; no significant changes were found in either study population. Fronto-orbital advancement in anterior craniosynostotic patients between the ages of 8 and 10 months seems to be ideal, as the procedure promotes solid cranial vault growth, ensuring positive surgical results.

Keywords: Anthropometric; Coronal suture; Craniosynostosis; Metopic suture; Scaphocephaly; Skull; Trigonocephaly.