title: Relapse in fronto-orbital advancement: a pilot study.
abstract: Our unit policy in fronto-orbital advancement (FOA) and remodeling has been initial overcorrection to improve the ultimate aesthetic outcome of surgery. To assess relapse of anteroposterior (AP) correction in patients with cranial synostosis undergoing FOA and remodeling, a retrospective pilot study identified patients from the unit database. Serial AP calvarial measurements were used to record surgical and postsurgical changes. Patients showing a change in measurements toward preoperative values were considered to have relapsed. Associated factors were recorded, and statistical analysis was carried out using SPSS.Thirty-one patients (female n = 10, male n = 21) with a median age at surgery of 17 months and a mean weight of 11 kg were included in the study. The mean hospital stay was 7 days. The mean advancement was 13 (SD, 4) mm, and relapse occurred in 65% (20/31). Mean AP relapse at 5 months was 6.2 mm. No patient required subsequent FOA. No significant correlation was found between relapse and age, weight, hospital stay, and syndromic status. Anteroposterior relapse of the fronto-orbital segment occurred in two thirds (65%) of our cohort at 5 months. A prospective study is now under way to analyze this further. The results of this pilot study suggest that strategies to minimize or to compensate for relapse may enhance the ultimate surgical result.
authors.affiliation: Merseyside Supraregional Craniofacial Unit, Alder Hey Children's Hospital, NHS Foundation Trust, Liverpool, United Kingdom. CTLwin@doctors.org.uk
authors.forename: Christine T-T J W
authors.initials: CT
authors.lastname: Lwin
authors.forename: David
authors.initials: D
authors.lastname: Richardson
authors.forename: Christian
authors.initials: C
authors.lastname: Duncan
authors.forename: Paul
authors.initials: P
authors.lastname: May
mesh_terms: D016009:Chi-Square Distribution; D002675:Child, Preschool; D003398:Craniosynostoses / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010865:Pilot Projects; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012086:Reoperation; D018709:Statistics, Nonparametric; D013524:Surgical Flaps; D016896:Treatment Outcome