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Non-syndromic trigonocephaly: surgical decision making and long-term cosmetic results

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Abstract

Background

Surgical correction is often required for cosmetic correction of trigonocephaly. The purpose of this paper was to report the long-term aesthetic outcome as appreciated by the parents/patients themselves. The self-evaluation of cosmetic outcome after trigonocephaly correction has not previously been reported. The management and different surgical techniques utilized over a 16-year period are discussed.

Materials and methods

An observational study was undertaken of the clinical outcome, operative data, complications and cosmetic satisfaction of these trigonocephaly patients. The parents/child were asked to rate their satisfaction with the cosmetic outcome both in terms of head shape and scar appearance, on a five-point scale (excellent—5, very good—4, good—3, fair—2 and poor—1).

Results

Sixty-three patients presented with non-syndromic trigonocephaly over the 16 years. Nineteen of 63 had a mild form of trigonocephaly and were managed conservatively. The remainder underwent surgical correction. Forty-two of 44 (95%) underwent fronto-orbital advancement with either barrel staving (26/44) or frontal bone rotation/re-modelling (16/44), with 2 of 44 having burring of the metopic ridge. Head shape rating was regarded as excellent in 25 of 63 (40%), very good in 18 of 63 (28%), good in 18 of 63 (28%) and fair in 2 of 63 (4%). Of those that underwent surgery, the scar was zigzag in 32 of 44 and straight in 12 of 44. Scar was rated as being excellent in 21 of 44 (48%), very good in 12 of 44 (28%) good in 11 of 44 (24%).

Conclusions

Metopic synostosis can result in varying degrees of severity. Milder forms can be treated conservatively, with more severe forms requiring both frontal bone re-modelling and fronto-orbital advancement. Surgical correction results in a high level of patient/parent satisfaction.

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Authors and Affiliations

  1. Department of Neurosurgery, Beaumont Hospital, Dublin, 9, Republic of Ireland

    Michael O. Kelleher, Mahmoud H. Kamel & David Allcutt

  2. Cleft and Craniofacial Department, Children’s University Hospital, Temple Street, Dublin, Republic of Ireland

    Dylan J. Murray, Anne McGillivary & Michael J. Earley

Authors
  1. Michael O. Kelleher
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  2. Dylan J. Murray
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  3. Anne McGillivary
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  4. Mahmoud H. Kamel
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  5. David Allcutt
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  6. Michael J. Earley
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Correspondence to Michael O. Kelleher.

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Kelleher, M.O., Murray, D.J., McGillivary, A. et al. Non-syndromic trigonocephaly: surgical decision making and long-term cosmetic results. Childs Nerv Syst 23, 1285–1289 (2007). https://doi.org/10.1007/s00381-007-0386-6

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  • DOI: https://doi.org/10.1007/s00381-007-0386-6

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