ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026
Distraction in anterior plagiocephaly: technique, risks, and long-term results.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe purpose of this study is to define the perioperative outcomes and long-term aesthetic outcomes of patients with unicoronal craniosynostosis (UCS) treated with fronto-orbital distraction osteogenesis (FODO) and compare them to a contemporaneous cohort treated with conventional fronto-orbital advancement and remodeling (FOAR).
methodsA retrospective review was performed for all patients treated at the Children's Hospital of Philadelphia for non-syndromic UCS from 2009-2025. Demographic and perioperative data were collected. Preoperative and 5-year or greater postoperative frontal 2D photographs were used to assess for facial, and specifically periorbital, symmetry. Symmetry ratios were calculated to assess periorbital facial morphometry.
resultsSixty-two patients were included in the study, 34 FODO, and 28 FOAR. FODO demonstrated significantly shorter anesthesia and surgical times, lower estimated blood loss, and shorter length of stay (all p < 0.001). The overall complication rate was similar (p = 0.175), but postoperative infection was more commonly reported in the FODO group (24 vs 1%, p = 0.033). Thirty-two patients had a 5-year or greater postoperative photographs, 16 FODO, and 16 FOAR. Patients in the FODO group were found to have greater improvements in palpebral width symmetry (0.32 vs -3.4, p = 0.039) and canthal tilt symmetry (1.51 vs -1.20 degrees, p = 0.035). One patient in the FOAR group required reoperation due to signs of elevated ICP.
conclusionFODO results in improved perioperative and long-term aesthetic outcomes compared to FOAR, resulting in improved canthal tilt and palpebral width symmetry. Future studies should focus on severity-matched analyses.
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