CRANIOFACIAL GROWTH-CHARACTERISTICS AFTER BILATERAL FRONTO-ORBITAL ADVANCEMENT IN CHILDREN WITH PREMATURE CRANIOSYNOSTOSIS

The standardized bilateral fronto-orbital advancement method of osteot omy established at the University of Wuerzburg is applied in all forms of craniosynostosis except scaphocephalus. The intention behind early operation is to halt progression of the disorder and to institute the physiological direction that growth should take. The preoperative sev erity of the disorder, the particular symptoms of the various malforma tions concerned, and the postoperative course of growth were analyzed and assessed both clinically and cephalometrically using the retrospec tive evaluations of the file data of 131 children with various forms o f craniosynostosis. In contrast to linear craniectomy and so-called la teral canthal advancement, which have sometimes been thought to lead t o undesirable postoperative growth development, only II relapses requi ring renewed operation were found postoperatively in our own study of 131 children, It became evident that the greater the severity of the m alformation, the more probable it was that a relapse would occur. Fron to-orbital advancement can only affect the pathologic growth pattern t o a limited degree, especially when craniosynostosis is related to a s yndrome. Cephalometric evaluation confirmed the limited potential for growth in the area of the anterior skull base and in the mid-face in t he presence of syndrome-related brachycephaly and severe facio-cranios ynostoses. In such clinical cases, compensatory growth of maxillary hy poplasia cannot be expected after fronto-orbital advancement.