{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:03:15Z","timestamp":1792710195407,"version":"4.5.0"},"reference-count":31,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The objective of this study was to investigate the longitudinal changes in cranial growth following fronto-orbital advancement (FOA) surgery in patients with unilateral and bilateral coronal craniosynostosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This retrospective review analyzed head circumference (HC) and CT data during preoperative (T0), immediate postoperative (T1), and final follow-up (T2) visits in 40 patients (23 female, 17 male) who underwent FOA using either the open approach or distraction osteogenesis (DO) between 1987 and 2018. The mean follow-up period was 90.62 months. The z-scores of HC, CT-based intracranial volume, anteroposterior diameter (APD), biparietal diameter (BPD), and cranial height (CH) were calculated using sex- and age-specific standards. Logistic regression analysis was performed.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>While the z-scores of HC, intracranial volume, and BPD remained within the normal range, the z-scores of APD fluctuated between \u22122 and \u22121, and the z-scores of CH were &gt; 2, indicating a substantial elevation compared with norms from T0 to T2. Age at surgery significantly influenced the z-scores of HC, BPD, and CH at T2 (all p &lt; 0.05). Delayed surgical timing was correlated with increased BPD and CH z-scores from T1 to T2 (p = 0.007 and 0.019, respectively). The DO for FOA resulted in elevated HC z-scores at T2 and increased APD from T0 to T1, followed by a significant APD relapse from T1 to T2.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>These findings suggest that delayed surgical timing may support better cranial growth, as indicated by increased HC at long-term follow-up. However, delayed timing is also associated with worsening abnormally elevated CH. Despite the immediate APD expansion and long-term HC increase with DO, potential relapse warrants caution. While intentional overcorrection of APD is recommended, careful consideration of surgical timing and planning is essential.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.6.peds24137","type":"journal-article","created":{"date-parts":[[2024,8,17]],"date-time":"2024-08-17T02:18:18Z","timestamp":1723861098000},"page":"519-525","source":"Crossref","is-referenced-by-count":4,"title":["Longitudinal analysis of cranial growth using comprehensive craniometric measurements after fronto-orbital advancement in coronal craniosynostosis"],"prefix":"10.3171","volume":"34","author":[{"given":"Sungmi","family":"Jeon","sequence":"first","affiliation":[{"name":"Division of Pediatric Plastic Surgery, Seoul National University Children\u2019s Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se Yeon","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pediatric Plastic Surgery, Seoul National University Children\u2019s Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert K.","family":"Oh","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Children\u2019s National Medical Center, Washington, DC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taekeun","family":"Yoon","sequence":"additional","affiliation":[{"name":"DA Plastic Surgery, Seoul, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jee Hyeok","family":"Chung","sequence":"additional","affiliation":[{"name":"Division of Pediatric Plastic Surgery, Seoul National University Children\u2019s Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukwha","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, CHA Bundang Medical Center, Gyeonggi-do, Republic of Korea;"},{"name":"Medical Big Data Research Center, College of Medicine, Seoul National University, Seoul, Republic of Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Ki","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Seoul National University Children\u2019s Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hoon","family":"Phi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Seoul National University Children\u2019s Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Yeoun","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Seoul National University Children\u2019s Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Seoul National University Children\u2019s Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung Jun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pediatric Plastic Surgery, Seoul National University Children\u2019s Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Plast Reconstr Surg","first-page":"1073e","article-title":"Thirty years later: what has craniofacial distraction osteogenesis surgery replaced?","volume":"145","author":"Hopper RA","year":"2020","unstructured":"Hopper RA, Ettinger RE, Purnell CA, Dover MS, Pereira AR, Tun\u00e7bilek G. 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