Long-term aesthetic results of craniofacial surgery for frontal plagiocephaly were evaluated by two observers who used a scoring system based on deformities typical for this type of craniosynostosis.
In this retrospective study, pre- and postoperative photographs of 59 patients were scored for items typical of frontal plagiocephaly: shape of the forehead, orbital dystopia, and temporal depression. Each item was quantified as normal or absent (0 points), a mild deformity (1 point) or a severe deformity (2 points).
Preoperatively, the most obvious deformity was the shape of the forehead, whereas postoperatively temporal retrusion was the main deformity. There was a good overall correction of the presenting deformities, with a decline in the mean score from 3.7 to 0.86. There was a statistically significant weak correlation between pre- and postoperative scores for orbital dystopia alone. This finding indicates that the severity of the initial disease is not a major contributor to the final result. Furthermore, the surgical outcome seemed to be stable over time and was not influenced by the timing of surgery if it took place when the children were between 6 and 15 months of age.
Early craniofacial correction for frontal plagiocephaly results in a stable, acceptable aesthetic outcome on which the initial deformity has little effect. The most common associated craniofacial characteristics are corrected well to very well when surgery is performed within the first 6 to 15 months of life. The main focus of the deformity in both the short and long term remains the temporal depression, and thus it requires extra attention during surgery.