Is Early Extended Unicoronal Suturectomy Effective in Reducting the Need for Calvarial Reconstruction in Anterior Plagiocephaly?

Although many clinical researchers are devoted to discovering the pathogenesis of early fusion of sutures in craniosynostosis, the behavior of the perisynostotic area after surgical excision of the fused suture is poorly understood. In this article, the authors aimed to evaluate the outcomes of extended coronal suturectomy on the shape of the fronto-orbital area. From January 2018 to January 2025, 36 patients with unicoronal synostosis underwent extended suturectomy from the anterior fontanelle to the zygomaticofrontal junction under loupe magnification. After at least 12 months of postoperative follow-up, 83.33% achieved good results (Whitaker classes I-II), 5.55% appeared likely to require future fronto-orbital augmentation (Whitaker class III), and 11.11% required fronto-orbital reconstruction (Whitaker class IV). It appears that with careful follow-up, postoperative management, and early detection, extended suturectomy could be a safe and effective primary treatment option in nonsyndromic unicoronal synostosis, compared to more advanced surgeries.