Correction of Unicoronal Synostosis With Springs: Two Patients With Improved Facial Symmetry

Madiha Bhatti-Søfteland; Jonas Mellgren; Karin Säljö; Peter Tarnow; Giovanni Maltese; Robert Olsson; Tobias Hallén; Lars Kölby

doi:10.1097/SCS.0000000000009842

Correction of Unicoronal Synostosis With Springs: Two Patients With Improved Facial Symmetry

J Craniofac Surg. 2024 Jan-Feb;35(1):10-12. doi: 10.1097/SCS.0000000000009842. Epub 2023 Nov 16.

Authors

Madiha Bhatti-Søfteland¹, Jonas Mellgren¹, Karin Säljö¹, Peter Tarnow¹, Giovanni Maltese¹, Robert Olsson², Tobias Hallén², Lars Kölby¹

Affiliations

¹ Department of Plastic Surgery, University of Gothenburg, The Sahlgrenska Academy, Institute of Clinical Sciences, Sahlgrenska University Hospital.
² Department of Neurosurgery, University of Gothenburg, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.

Abstract

Objective: Surgical correction of unicoronal synostosis (UCS) entails extensive cranioplasties which do not address facial scoliosis. This paper presents the first results with springs that motivated the shift from extensive cranioplasties to dynamic techniques for surgical correction of UCS.

Methods: Two cases of UCS were operated with a linear osteotomy combined with springs. The deviation in facial symmetry (orbital dystopia angle) and skull base angles were measured on pre and postoperative computed tomography scans until 3 years of age.

Results: The facial scoliosis was corrected. At spring removal, the orbital dystopia angle had gone from a 9.2 to 13.2-degree deviation preoperatively to a 0.5 to 0.9-degree overcorrection compared with the ideal 0-degree deviation. Also, the skull base deviation improved.

Conclusion: Linear osteotomy combined with springs corrects the facial scoliosis in UCS. These cases indicate that dynamic methods may be beneficial for improving the results of surgical correction of UCS.