Background and Purpose:Treatment of metopic craniosynostosis often involves bitemporal expansion of the anterior cranium. This report compares perioperative variables of a surgical technique in which the fronto-orbital bandeau is bent in situ to traditional fronto-orbital advancement and remodeling (FOAR).Method/Description:Six patients undergoing the hinge technique were compared to the senior author's 6 most recent conventional FOARs. Study and control cohorts were reasonably well matched for age and sex; only those with nonsyndromic, single-suture metopic synostosis were included. Perioperative variables such as OR time, blood loss, hardware costs, length of stay, and perioperative complications were compared between groups using unpaired t tests.Results:Operative time was significantly decreased when the hinge technique was utilized, with a mean operative time of 159±14.0minutes for hinge patients and 193±33.8minutes for nonhinge patients (P=0.049). Hardware was also significantly decreased from an average of 2.2±1.0 plates and 35±13.8 screws in nonhinge patients to 1 plate and 20 screws in each hinge patient (P<0.02), for an average hardware saving of $2990 per hinge surgery (P=0.019). Estimated blood loss, length of stay, and perioperative complications were not significantly different between groups. All patients in both groups had Whitaker 1 outcomes in short-Term follow-up.Conclusions:The hinge technique for the treatment of metopic synostosis is associated with a statistically significant decrease in operative time, hardware utilization, and hardware cost. Perioperative outcomes were similar between the hinge technique and traditional FOAR in the short term, and additional follow-up is needed to determine whether the 2 have similar long-Term outcomes.
- surgical technique
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