Growth of the anterior cranial base after craniotomy in infants with premature synostosis of the coronal suture.

The effect of early craniotomy (age range: 1-6 months) on the growth of the cranial base was studied in 9 subjects with different types of premature synostosis affecting the coronal suture. In 5 of them the premature fusion involved only growth sites in the coronal suture growth complex, while the remaining 4 cases had a diagnosis of a craniofacial synostosis syndrome, such as Apert, Crouzon and Pfeiffer. In all but one of the patients, the craniotomy was not only extended down to the inferior orbital fissures but was also combined with the release of a free-floating fronto-supraorbital bone flap. Follow-up roentgencephalometry to ages ranging from 10 to 36 months indicated that the length and the growth of the anterior cranial base improved considerably after the craniotomy. However, complete normalization did not occur, especially in the subgroup with craniofacial synostosis syndromes. The mid-face of these patients also remained deficient in spite of the craniotomy.