Trigonocephaly: surgical considerations and long term evaluation.
Trigonocephaly accounts for approximately 10% of all craniosynostosis. Severe trigonocephaly results in a triangular-shaped forehead, superior-lateral orbital depression, hypotelorism, and compensatory occipital-parietal calvarial changes. Radiographic findings include ovoid orbits with parallel medial borders, thickened keel-shaped frontal bone, small ethmoid sinuses, and a short anterior cranial fossa with pitched sphenoid wings. Our experience with 50 infantile cases of severe nonsyndromic trigonocephaly patients treated from 1987 to 2005 is clinically reviewed to assess long-term growth based on a standardized operative technique. The average age of the patients at surgery was 6 months and the mean follow-up was 12 years. Our complication rate was 2%; the reoperative rate was 12%. The use of resorbable rigid plate fixation combined with alloplastic augmentation has improved the cosmetic outcome in patients treated since 1996 and reduced the reoperative rate.
Greenberg
Burt M
BM
Division of Plastic and Reconstructive Surgery, Department of Surgery, Einstein Medical Center, and Winthrop University Hospital, North Shore University Hospital-Long Island Jewish Health Care System, Manhasset, New York, USA. BGreenB@aol.com
Schneider
Steven J
SJ
D020341:Absorbable Implants; D001843:Bone Cements / Q000627:therapeutic use; D001860:Bone Plates; D018786:Bone Substitutes / Q000627:therapeutic use; D002675:Child, Preschool; D035262:Cranial Fossa, Anterior / Q000002:abnormalities / Q000000981:diagnostic imaging; D003393:Cranial Sutures / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D003398:Craniosynostoses / Q000000981:diagnostic imaging / Q000601:surgery*; D004954:Esthetics; D005005:Ethmoid Sinus / Q000002:abnormalities / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D005624:Frontal Bone / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009915:Orbit / Q000002:abnormalities / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000002:abnormalities / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D001843:Bone Cements; D018786:Bone Substitutes