Apert Syndrome

Calvarial vault remodeling: This procedure addresses the craniosynostosis by releasing the fused suture and allowing expansion and reshaping of the skull. This operation is usually performed before 1 year of age.

LeFort 3: This procedure addresses the midface deficiency by advancing the midface. It can be done as a direct advancement (for small movements), or as a distraction (for large movements). This operation is usually performed between 7 and 10 years of age.

Monobloc/facial bipartition: This procedure involves advancing the forehead as well as the midface in one piece, as well as removing bone from between the orbits to bring them closer to each other if hypertelorbitism is present. It can be done as a direct advancement (for small movements), or as a distraction (for large movements). This operation is usually performed between 7 and 10 years of age.

Box osteotomy: This procedure allows movement of the orbits in any directions, usually to narrow the distance between the eyes. This operation is usually performed after 12 years of age, after the permanent canines have erupted.

Orthognathic surgery: Final orthognathic surgery is performed to improve the bite after the child has finished growing, around 16 for girls and around 18 for boys.

Rhinoplasty: Rhinoplasty is usually the final facial operation in Apert children. It sometimes involves the use of rib graft to improve the projection of the nose.