Unilateral coronal craniosynostosis causes about 15% of all isolated craniosynostosis cases. Unlike sagittal and metopic suture craniosynostosis where the changes in the head shape are symmetric, closure of one coronal suture creates a significant uneven appearance to the skull and face.
These patients have flat foreheads and raised eye sockets on the side of the closed coronal suture. On the side with the open coronal suture, their forehead is fuller and the eye socket is vertically shorter. This uneven appearance is the result of constricted growth on one side and compensatory growth on the other.
The role of strip craniectomy and using a postoperative helmet in these patients is not yet clear, although we do occasionally offer this on a case-by-case basis. The mainstay of treatment in these patients has been an open cranial vault remodeling with a fronto-orbital advancement. This allows the surgeon to over correct the closed side and reshape the eye socket to allow the patient to “grow into” the correction.