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New research · Ophthalmology
Annals of plastic surgery · 2d
Systematic reviewAnnals of plastic surgery · 2026

Unilateral Versus Bilateral Fronto-Orbital Advancement in Non-Syndromic Unicoronal Craniosynostosis: A Systematic Review and Pooled Data Analysis.

Serhat Şibar, Halil Şafak Uygur, Pelin Kuzucu
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OphthalmologySystematic review

Contour deformity is more common after unilateral than bilateral fronto-orbital advancement.

Unilateral Versus Bilateral Fronto-Orbital Advancement in Non-Syndromic Unicoronal Craniosynostosis: A Systematic Review and Pooled Data Analysis.

Serhat Şibar … Pelin Kuzucu
Annals of plastic surgery · 2026
Background

Nonsyndromic unicoronal craniosynostosis (nonsyndromic unicoronal craniosynostosis) is characterized by asymmetric craniofacial deformity and remains one of the most challenging entities in craniofacial surgery.

Purpose

The present study aims to compare surgical outcomes, complication profiles, and long-term stability between unilateral and bilateral FOAR to clarify selection criteria for surgical technique.

Methods

A systematic review was conducted using the PubMed, Web of Science, and Cochrane databases, following PRISMA guidelines.

n = 511 patients
Results

unilateral surgery caused shape irregularities more often than bilateral surgery

75%
Unilateral FOAR
27.5%
Bilateral FOAR
More results

Of the included patients, 315 (61.6%) underwent bilateral FOAR and 196 (38.4%) underwent unilateral FOAR.

Due to heterogeneous reporting across studies, postoperative strabismus outcomes could not be reliably compared using pooled analysis.

“
Conclusion · 1 of 3

Both unilateral and bilateral FOARs provide effective correction of craniofacial asymmetry in nonsyndromic unicoronal craniosynostosis, but they differ in their complication profiles.

Conclusion · 2 of 3

Unilateral FOAR offers reduced surgical exposure and shorter operative duration but has a higher rate of contour irregularities.

Conclusion · 3 of 3

Bilateral FOAR achieves more comprehensive orbital and forehead correction, albeit with longer operative times and broader surgical exposure.

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