Clinical and Imaging Findings and Postoperative Esthetic Results in Patients with Single or Bilateral Coronal Synostosis

Aims: Coronal synostosis is presented either singular or bilateral. We report on the case of the clinical presentation, corresponding imaging findings and the esthetic results of patients with coronal synostosis following surgical intervention.

Methods: Between 2000 and 2014, 14 children with coronal synostosis (eight unilateral, six bilateral including three cases with Saethre-Chotzen Syndrome) underwent surgical intervention (bilateral fronto-orbital advancement). The age at surgery was 8 to 17 months. The presurgical diagnosis included ultrasound examination and/or CT with 3D reconstruction, and with the consent of the parents, a photo documentation. Average follow-up period was 32 months. To evaluate the postoperative esthetic, result scores were graded on a scale 1 to 5 (1 = harmonic skull shape, very good result, 2 = minor irregularities of the skull surface, good esthetic result, 3 = minor asymmetries, esthetically satisfying result, 4 = greater asymmetries, discussion about surgical revision or correction, and 5 = inadequate esthetic result). The postoperative result was photo documented again if parents agreed.

Results: The outcome for esthetic results showed an overall good degree of satisfaction by the attending physicians as well as by the patients' parents. Representative cases of each group (singular and bilateral coronal synostosis) are presented.

Conclusion: Esthetic result following bilateral fronto-orbital advancement in coronal synostosis is good. For final evaluation, a longer follow-up period is needed.

Keywords: coronal synostosis, clinical presentation, imaging findings, esthetic results.