Inner table corticectomy of the fronto-orbital bar in correction of metopic and coronal craniosynostoses.
Fronto-orbital advancement is an established method for correction of metopic and coronal craniosynostoses. Many techniques involve creation of a single fronto-orbital bar that is then shaped with osteotomies with or without bone grafting. We present a technique that minimizes osteotomy of the frontal bar and gives superior lateral brow aesthetics.Standard fronto-orbital bar bone cuts are made without a midline osteotomy. Selective inner table corticectomy of the fronto-orbital bar allows the bone to become malleable without greensticking. The need for osteotomy of the fronto-orbital bar is obviated. An additional bandeau is created from the temporoparietal calvaria. The malleable fronto-orbital bar is then fixed to this bandeau. The frontal bar and bandeau complex is then advanced in a conventional manner. The remaining frontal calvaria is then rotated creating a more vertical forehead.This technique has been used in Leeds for more than 10 years with good cosmetic results. It has become our standard method for management of the fronto-orbital bar in correction of nonsyndromic metopic and coronal craniosynostoses.
Craniofacial Surgery, Leeds General Infirmary, Leeds, England. lachlan.carter@leedsth.nhs.uk
Lachlan M
LM
Carter
Iain
I
Varley
Ian M
IM
Smith
Paul
P
Chumas
Mark
M
Liddington
John L
JL
Russell
D003398:Craniosynostoses / Q000601:surgery*; D005624:Frontal Bone / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D009915:Orbit / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D013524:Surgical Flaps