Neo-Bandeau: Technical Description and Early Outcomes From a Single-Center Case Series

Purpose: The neo-bandeau is a single-segment modification of traditional fronto-orbital advancement (FOA) intended to simplify reconstruction of the frontal bone and superior orbits while potentially improving contour and reducing temporal hollowing. We describe our operative approach and report early clinical outcomes from a single-center case series. Methods: Following Institutional Review Board approval, a retrospective review was performed of patients treated for craniosynostosis at a tertiary academic center from database inception through April 2025. Patients were included if they underwent open anterior cranial vault reconstruction using a neo-bandeau FOA technique. Demographics, diagnosis, operative details (estimated blood loss, transfusion, operative duration), hospital course (ICU stay, length of stay), complications, and short-term follow-up outcomes were extracted from the medical record. Results: Four patients underwent neo-bandeau FOA: 3 with metopic craniosynostosis and 1 syndromic patient with combined sagittal and metopic craniosynostosis. Estimated blood loss ranged from 75 to 500 mL. Three patients received intraoperative red blood cell transfusion, and 2 received postoperative packed red blood cells on postoperative night 1. Operative duration ranged from 3 hours 26 minutes to 4 hours 8 minutes. All patients were managed postoperatively in the pediatric ICU (1-2 days) and then transferred to the surgical floor. Total hospital length of stay ranged from 3 to 6 days. There were no intraoperative complications, no perioperative surgical complications documented during the index admission, and no adverse events reported at follow-up (range: 4 months to 1.5 years). Representative pre- and postoperative imaging demonstrated improved frontal and supraorbital contour. Conclusions: In this small single-center series, neo-bandeau FOA was feasible and reproducible, with early outcomes suggesting an acceptable safety profile and encouraging short-term esthetic results. Larger studies with longer follow-up are needed to define long-term cranial growth, contour stability, and rates of secondary deformities compared with traditional FOA.