title: The effect of fronto-orbital advancement on strabismus in children with unicoronal synostosis.
abstract: Unicoronal synostosis is frequently associated with strabismus. While the literature reports on the underlying bony dysmorphology and associated extraocular muscle dysfunction, the effect of the bony changes of fronto-orbital advancement has unpredictable effects on the strabismus associated with unicoronal synostosis. Previous authors have reported both resolution and new onset of strabismus following fronto-orbital advancement. The purpose of this study is to document the incidence of strabismus in patients with unicoronal synostosis and to assess the effect of fronto-orbital advancement on strabismus. A retrospective review of 20 patients with unicoronal synostosis was performed. The results demonstrated that 90% of our patients were noted to have strabismus preoperatively and this persisted postoperatively. Despite fronto-orbital advancement, strabismus persisted postoperatively. Seven (36.8%) required extraocular muscle surgery. In this series of patients with unicoronal synostosis there was a higher incidence of strabismus than previously reported elsewhere. Correction of the recessed frontal bone with bilateral fronto-orbital advancement does not fully address the orbital bony dysmorphology or correct the extraocular muscle dysfunction associated with unicoronal synostosis.
authors.affiliation: Department of Plastic and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Australia.
authors.forename: Shu Jin
authors.initials: SJ
authors.lastname: Lee
authors.forename: Joanne
authors.initials: J
authors.lastname: Dondey
authors.forename: Andrew
authors.initials: A
authors.lastname: Greensmith
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Holmes
authors.forename: John G
authors.initials: JG
authors.lastname: Meara
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005624:Frontal Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D009915:Orbit / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013580:Synostosis / Q000601:surgery*