Unicoronal: Noel

Noel presented to the craniofacial team at 2 weeks of age for evaluation of his asymmetric head shape. His photos from that visit (LEFT) show that he his left coronal suture is has closed prematurely (left unilateral coronal craniosynostosis). On his left side the opening of the eyelids (palpebral aperture) is wider than the right side. The left eyebrow appears raised and the forehead is very flat on the left, all from failure of the forehead to grow forward because of the closed suture. The right forehead is bulged forward and the eye opening is narrow because of excessive forward growth as the right coronal suture to compensate for the closed left coronal suture. Noel was treated with a fronto-orbital advancement and calvarial vault remodeling at 9 months of age. The goal of surgery is to overcorrect the position of the forehead and upper half of the eye socket (orbit) on the side of the closed suture. This is done to achieve symmetry when the child’s skull has completed growth, which is approximately at school age. The 1-year postoperative photos on the right side of the screen show improvement in the position of the forehead and symmetry between the left and right sides. A slight overcorrection of the forehead and upper portion of the orbit is still present as Noel continues to “grow into” the desired correction.

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