Original ArticlesThe Effect of Fronto-Orbital Advancement on Frontal Sinus Development and Function in Non-Syndromic and Syndromic CraniosynostosisDeraje, Vybhav MS, DNB*; Jirapinyo, Chutima MD, FRCST*; Taranath, Ajay MD, FRANZCR†; Anderson, Peter J. PhD, FRACS*; Moore, Mark H. MBChB, FRACS*Author Information *Australian Craniofacial Unit †Department of Medical Imaging, Women's and Children's Hospital, Adelaide, Australia. Address correspondence and reprint requests to Vybhav Deraje, MS, DNB, Australian Craniofacial Unit, Women's and Children's Hospital, 72, King William Road, North Adelaide, SA 5006, Australia; E-mail: firstname.lastname@example.org Received 26 July, 2019 Accepted 18 November, 2019 The authors report no conflicts of interest. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcraniofacialsurgery.com). Journal of Craniofacial Surgery: May 2020 - Volume 31 - Issue 3 - p 707-710 doi: 10.1097/SCS.0000000000006232 Buy SDC Metrics Abstract The impact of fronto-orbital advancement (FOA) on frontal sinus development and function is anecdotally variable. The aim of this study was to assess the impact of FOA on development of frontal sinuses, and additionally to identify the complications that might arise out of such procedures. This was a retrospective case-control study. Non-syndromic and syndromic craniosynostosis patients (n = 58) who underwent FOA at an early age and also had a skull radiograph or CT scan after the age of 12 were selected. Age matched trauma patients with CT scans done beyond 12 years of age were used as controls. Age at first FOA surgery, total number of procedures and age at imaging was noted. Presence or absence of frontal sinuses was assessed using imaging studies initially. Patients with a formed frontal sinus and a CT scan were further chosen for volumetric studies. Complications related to frontal sinus and secondary surgeries were recorded. One of 27 non-syndromic patients had absent frontal sinuses. Seven of 31 syndromic patients had absent sinuses. Among 20 controls, only 1 patient did not develop frontal sinuses. The mean age at first FOA was 11.81 months and 18.25 months for non-syndromic and syndromic groups, respectively. The average number of procedures before 12 years of age was 1.25 and 1.51 for non-syndromic and syndromic patients, respectively. The mean age at imaging was 17.74, 20.96, and 20.25 years for non-syndromic, syndromic and control groups, respectively. The mean frontal sinus volumes were 13050.36, 15039.02, and 8459.48 mm3 for non-syndromic, syndromic and control groups, respectively. In conclusion, FOA does not seem to have an impact on rate of pneumatization in the background of similar rates in the non-syndromic and control groups. The low pneumatization rate in syndromic group might be a virtue of the disease itself. There were significant frontal sinus complications that occurred after fronto orbital advancement and this should be borne in mind during the surgical consenting process. © 2020 by Mutaz B. Habal, MD.