Is Reverse frontal cranioplasty eligible for the correction of both the forehead deformities and the intracranial hypertension in craniosynostosis? Comparison of the preoperative and postoperative intracranial volumes

Abstract Reverse frontal cranioplasty (RFC) is a procedure allowing the correction of forehead deformities related to craniosynostosis sequelae with a substantial increase of the intracranial volume (ICV). This study aimed to describe the surgical technique, the aesthetical modification as well as the modification of ICV to assess its potential eligibility for the treatment of the intracranial hypertension (IH). A retrospective monocentric study included the patients displaying an history of craniosynostosis with a forehead deformity and who underwent RFC from 2008 to 2019 at the University Hospital center of Tours (France). A subjective outcome questionnaire (SOQ) was conducted with each patient or their parent to determine their level of satisfaction after RFC. Pre and postoperative CT scans were analyzed and compared to investigate the ICV change and fronto-nasal angle. Eleven patients were included in the study, (6 females, 5 males) with a mean age of 10.9 years old (range 3–23 Y.O.) and an average follow-up of 4.5 years (1–11 Y.O.). All patients responded to the questionnaire with a high level of overall satisfaction (mean 9.1/10). The mean preoperative FNA was 134°± 5° while the mean postoperative angle was 126.4°±6, corresponding to an average decrease of 7.6° (95% CI, 4.0-11.2°; p