Vascularized fronto-orbital advancement

The Journal of Craniofacial Surgery
H W LoskenV K Singhal

Abstract

Fronto-orbital advancement is the procedure of choice for correction of fronto-orbital recession resulting from coronal synostosis in children. However, long-term follow-up evaluations often reveal "undercorrection" of the deformity with development of recurrent recession of lateral supraorbital regions. One factor that may contribute to this process is devascularization of the fronto-orbital bar during its reshaping and advancement. If subsequent revascularization is suboptimal, excessive resorption or inadequate growth of the bar may lead to supraorbital recession. On the basis of studies of temporal bone grafts, which have shown that vascularized grafts are superior to free bone grafts in terms of bone graft survival, we postulated that maintaining vascularization of the fronto-orbital bar would favor better healing and growth that would translate to more favorable aesthetic results. Herein, we review the vascular anatomy of the fronto-orbital region and report the application in six patients of a technique for fronto-orbital advancement that preserves a significant portion of this blood supply. Technical caveats involved in the successful application of this approach are discussed. The attachment of the periosteum to the la...Continue Reading

Citations

May 14, 2014·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Harib H EzaldeinDerek M Steinbacher
Aug 24, 2012·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Concezio Di RoccoGianpiero Tamburrini
Jul 7, 2014·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Philipp MetzlerDerek M Steinbacher
Oct 27, 2017·The Journal of Craniofacial Surgery·Katelyn G BennettSteven R Buchman
Jan 18, 2011·The Journal of Craniofacial Surgery·Cameron S FrancisSteven R Cohen
May 15, 2007·Plastic and Reconstructive Surgery·Mark P MooneyMichael I Siegel
Sep 7, 2007·Plastic and Reconstructive Surgery·Shadi GhaliJoseph G McCarthy
Dec 6, 2005·The Journal of Craniofacial Surgery·Yasushi FujimoriSosuke Oba
Mar 17, 2012·The Journal of Craniofacial Surgery·Anup PatelJohn A Persing
Aug 17, 2002·Neurosurgery·Rodrigo Ramos-ZúñigaSandra Trejo

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