{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:24:49Z","timestamp":1791617089215,"version":"4.3.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare outcomes of cranial vault remodeling via fronto-orbital advancement and remodeling (FOAR) versus spring cranioplasty in patients with nonsyndromic unicoronal craniosynostosis (UCS), focusing on surgical parameters and craniofacial symmetry improvements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective review comparing FOAR and spring-assisted cranioplasty outcomes using preoperative and postoperative CT data. Statistical analysis was performed using SPSS Statistics 30.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Institutional tertiary care center specializing in craniofacial surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants<\/jats:title>\n                    <jats:p>\n                      Nonsyndromic patients with UCS undergoing FOAR (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20097) or spring cranioplasty (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200911), with complete pre- and postoperative imaging and surgical data available.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>FOAR involved traditional fronto-orbital advancement and remodeling. Spring cranioplasty consisted of spring placement followed by spring removal surgery, designed to remodel cranial vault less invasively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Retrospective review of surgical time, estimated blood loss (EBL), packed red blood cells (PRBC) transfused, intracranial volume (ICV), facial twist (FT), skull-base twist relative to palate (SBT-P) and nasion (SBT-N), and orbital morphology symmetry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Spring cranioplasty, when considering both placement and removal, significantly reduced operative time (157.9\u2009\u00b1\u200928.6 vs 264.7\u2009\u00b1\u200948.3\u2005min), EBL (5.5\u2009\u00b1\u20091.6 vs 26.5\u2009\u00b1\u20099.2\u2005mL\/kg), and PRBC transfusion (2\u2009\u00b1\u20094.2 vs 27.4\u2009\u00b1\u20095.9\u2005mL\/kg) compared with FOAR (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Postoperatively, patients who underwent spring cranioplasty demonstrated significant improvements in FT, SBT-P, and SBT-N (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.003), whereas FOAR did not achieve significant changes. ICV did not differ significantly between groups. Spring cranioplasty patients demonstrated superior orbital symmetry improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Spring cranioplasty offers a less invasive alternative to FOAR for UCS, with shorter surgery, less blood loss, and better craniofacial symmetry correction without compromising ICV expansion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251401323","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T19:32:53Z","timestamp":1764703973000},"page":"404-415","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of Cranial Vault Remodeling Versus Spring Cranioplasty for Nonsyndromic Unicoronal Craniosynostosis: Analysis of Outcomes"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7780-8394","authenticated-orcid":false,"given":"Sarah Anne","family":"Frommer","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery and Perioperative Care, Dell Medical School, Austin, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3586-3732","authenticated-orcid":false,"given":"Sebastian","family":"Kuriakose","sequence":"additional","affiliation":[{"name":"University of Texas at Austin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick D.","family":"Combs","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery and Perioperative Care, Dell Medical School, Austin, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth C.","family":"Tyler-Kabara","sequence":"additional","affiliation":[{"name":"Dell Medical School"},{"name":"Department of Pediatrics, Dell Medical School, Austin, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick K.","family":"Kelley","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery and Perioperative Care, Dell Medical School, Austin, TX, 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