Thirty-five patients with craniosynostosis underwent fronto-orbital advancement and cranial remodeling assisted by gradual distraction between 1998 and 2002. Twenty-six cases with over twelve-months follow up period were checked in all cases. Seven cases were syndromic and 19 non-syndromic. The patients ranged in age from 4 to 50 months (mean 12.7 months). Simulated surgery was first performed on a 3-D solid model made of polyurethane that accurately represented cranial flexibility in order to determine the most favorable osteotomy line. Distraction was initiated one week postoperatively. The speed and extent of advancement (maximum 50 mm) were predetermined using previously reported criteria and the simulated surgery. The postoperative configuration was favorable in all cases. Irregularities and/or gaps after distraction, especially in cases of trigonocephaly and scaphocephaly. No patient displayed major perioperative complications. There were minor complications in eight cases including exposure of the device, the shaft slipping off, and fluid discharge. A three-year follow-up showed no relapse of the advanced bones. Highly satsifactory results were achieved in both syndromic and non-syndromic craniosynostosis.

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