{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:40:20Z","timestamp":1793716820207,"version":"4.6.1"},"reference-count":42,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"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":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Objective<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Strip craniectomy (SC) and fronto-orbital advancement (FOA) are 2 techniques for the management of unilateral coronal synostosis (UCS) that differ in timing and approach. However, the tempo and extent of postoperative changes in craniofacial features are less well understood. The purpose of this study is to evaluate the progression of craniofacial symmetry over time following SC or FOA in UCS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Design<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>A retrospective review of 3-dimensional images obtained preoperatively and at 1- and 2-year postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Setting<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Tertiary pediatric institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Patients, Participants<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Thirty-six patients with UCS and 36 control patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Interventions<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Strip craniectomy with helmet or FOA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Main Outcome Measure(s)<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Three-dimensional craniometric asymmetry measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Results<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>\n                      The SC group had significantly shorter operative time, less blood loss, and a shorter hospital length of stay. All craniofacial symmetry measurements significantly improved postoperatively in both groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05), except for orbital width asymmetry in the FOA group at both 1 year and 2 years postoperatively (93.63\u2009\u00b1\u20093.53%; 93.60\u2009\u00b1\u20097.41%). There was no significant difference in craniofacial asymmetry measurements between groups. The orbital width (95.15\u2009\u00b1\u20093.95%) and midface (96.12\u2009\u00b1\u20093.15%) asymmetry in the SC group remained significantly different from controls at 2 years postoperatively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). The cranial asymmetry (96.43\u2009\u00b1\u20092.63%), orbital width asymmetry (93.60\u2009\u00b1\u20097.41%), and midface asymmetry (96.53\u2009\u00b1\u20091.61%) in the FOA group remained significantly different from controls at 2 years postoperatively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.009;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.042;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.015).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Conclusions<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Strip craniectomy and FOA both improved craniofacial symmetry over time, though orbital width and midface differences persisted compared to controls at 2 years postoperatively. Fronto-orbital advancement also showed a persistent cranial asymmetry compared with controls.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261446314","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T15:02:26Z","timestamp":1777042946000},"page":"4365-4374","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Craniofacial Symmetry Progression Following Strip Craniectomy Versus Fronto-Orbital Advancement in Unilateral Coronal Synostosis"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3168-1879","authenticated-orcid":false,"given":"Lucas M.","family":"Harrison","sequence":"first","affiliation":[{"name":"University of Texas Southwestern Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9025-399X","authenticated-orcid":false,"given":"Rami R.","family":"Hallac","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paymon","family":"Sanati-Mehrizy","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Seaward","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex A.","family":"Kane","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical 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