Non-syndromic bilateral coronal craniosynostosis is rare, making up about 5-10% of cases. These patients have a broad, flat forehead. The skull is short from front to back and it is tall and wide. The back of the skull is typically very flat. The upper parts of the eye sockets are recessed.
These patients will eventually require a fronto-orbital advancement in order to achieve a normal appearance to the forehead and eye sockets. Recently, posterior cranial vault distraction has emerged as a powerful procedure in these patients. Cranial distraction uses specialized devices called distractors to move the skull bones slowly, to allow the scalp to stretch as the bones move. The scalp is ususally what limits how much we can correct the head shape in a single operation. Distraction allows for twice as much expansion of the skull as single stage procedures. Expanding the back of the head creates space for the growing brain and allows us to delay the reshaping of the forehead and eye sockets to an age closer to the completion of skull growth.