Fronto-Orbital Advancement (FOA)

What is Fronto-Orbital Advancement (FOA)?

Fronto-orbital advancement (FOA) is a surgical procedure that has been used to treat craniosynostosis for decades. The surgical goals of a Fronto-orbital advancement (FOA) are to expand the space inside the skull and to reshape the forehead and upper part of the eye socket (orbit). In some cases this can protect the eyes by improving the eyelid position and improves appearance. 

Fronto-orbital advancement (FOA) can be performed in many different ways, because this surgery is used for patients with craniosynostosis affecting either the metopic, one or both coronal sutures.

What are the benefits of Fronto-Orbital Advancement (FOA)?

Fronto-orbital advancement (FOA) is a surgery that is used in both syndromic and non-syndromic patients, however it tends to have better, more lasting effects in non-syndromic craniosynostosis patients because the remainder of their bones grow at a normal rate.

What can I expect with Fronto-Orbital Advancement (FOA)?

The longer that we safely can wait to perform the fronto-orbital advancement, the better the chance of the patient having better skull growth and a normal appearance. For this reason, we will perform a posterior cranial distraction as a first procedure and wait for the skull to be close to fully grown before performing the frontal-orbital advancement (FOA).

Sometimes the patient’s eye sockets may be so shallow that the eyelids cannot close enough to protect the eye. If this is not corrected early, the patient can have permanent scarring to the eye. If the risk for sight loss is very high, we will either partially close the eyelids with suturing techniques (tarsorrhaphy) or perform a fronto-orbital advancement as our first cranial vault procedure to put the eyelids in a better position to protect the eyes.