PRS AAPS Oral Proofs 2016
Patrick Gerety, MD, Wen Xu, BS, Jing Li, MD, Daniel Mazzaferro, MBA, Scott Bartlett, MD, Jesse Taylor, MD
From the Children’s Hospital of Philadelphia, Philadelphia, Pa.
PURPOSE: Fronto-orbital advancement (FOAR) potentially injures frontal sinus buds, leading to poor pneumatization and rhinosinusitis. This study aims to measure frontal sinus volume and incidence of sinusitis in craniosynostosis patients who have undergone FOAR and to compare them with controls.
METHODS: We conducted a retrospective review of all craniosynostosis patients treated with FOAR in infancy at our craniofacial center. Frontal sinus morphology and volume were assessed with Mimics. Sinus disease was defined as mucosal thickening or sinus fluid. Unaffected age-matched controls were identified from a facial trauma database.
RESULTS: We included 100 craniosynostosis and control subjects. The rate of frontal sinus pneumatization was 81% in syndromic craniosynostosis, 94% in nonsyndromic craniosynostosis, and 95% in control subjects (P = 0.172). Average volume was 4.46 ml in syndromic craniosynostosis, 4.13 ml in nonsyndromic craniosynostosis, and 4.38 ml in control subjects (P = 0.9311) and was significantly correlated with the age at which the computed tomography scan was performed (P = 0.0034). Pneumatization rates and volume did not significantly correlate with age of initial FOAR, number of frontal surgeries, or age at most recent surgery. Evidence of frontal sinus disease was highest in the syndromic group (P = 0.002), with 3 syndromic patients requiring surgical intervention for frontal sinus disease.
CONCLUSIONS: Although syndromic patients demonstrated lower pneumatization rates and higher sinus disease rates, FOAR does not significantly impact frontal sinus development and pathology.