[Outcome of profile-improving operations in craniofacial abnormalities].

In 52 children with craniosynostosis, we studied the effect of fronto-orbital advancement onto the forehead profile and the growth tendency of the forehead and midface. As a reference, the following kephalometric data were used: SN line. N-Spna line, SNA angle, N-tf line (as an indicator of the forehead profile) and the tf-TF line (as an indicator of the forehead size). The operation was carried out at an mean age of 10.5 months. Follow-up with X-ray control covered a period of 37.2 months on average. In patients with brachycephalus the SNA line was reduced and the post-operative growth tendency was the most unfavorable. Also the forehead profile (N-tf-line) did not become normal after the operation in patients with brachycephalus. Besides this, the increase in the forehead size indicated a new growth-tendency disorder. In all children with brachycephalus as well as in most children with oxycephalic growth tendency, sagittal midface growth was inhibited (NSA angle) while vertical midface growth was normal (N-Spna line). The success of fronto-orbital advancement was dependent on the kind of growth disorder, the location, and the age when the operation was carried out. Only early operative treatment could interrupt the pathological growth tendency even in cases with a major development disorder.