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This article outlines the latest evidence-based recommendations for managing unilateral coronal craniosynostosis, based on the 2021 update published in the Journal of Craniofacial Surgery. These guidelines draw from a comprehensive review available online, providing insights into surgical and non-surgical approaches.
Recommendations for surgery vary among specialists. Importantly, the head shape associated with unilateral coronal craniosynostosis does not improve naturally with age, highlighting the need for careful evaluation.
For treating unilateral coronal craniosynostosis surgically, no single method is universally recommended due to limited evidence. One study suggests that minimally invasive procedures may offer less improvement in the aesthetics of the orbital frame compared to more extensive forehead reshaping surgeries. However, another analysis indicates comparable outcomes between the two approaches.
A large-scale study involving 207 participants, with long-term follow-up, found no instances of increased intracranial pressure six years after forehead reshaping surgery for unilateral coronal craniosynostosis. Post-operative observations include potential depressions on both sides of the head and the upper outer orbital frame, which may persist up to five years. Further long-term studies are essential to assess final results.
Evidence comparing the timing of minimally invasive surgery (around six months) versus forehead reshaping (after six months) is available, but it does not address intracranial pressure differences. Decisions should weigh individual patient factors.
Monitoring is advised regardless of whether surgery is performed. The risk of increased intracranial pressure in unilateral coronal craniosynostosis is low, so routine fundoscopy is not necessary. However, annual tracking of head circumference is recommended. If measurements deviate from standard growth curves—available in pediatric manuals or online resources, typically up to age five—further evaluation via fundoscopy or computed tomography may be warranted.