['Metopic synostosis results in trigonocephaly with bitemporal narrowing. Treatment involves differential fronto-orbital advancement, widening of the bitemporal region, and rounding the forehead. The purpose of this article was to implement three-dimensional surgical planning to treat metopic synostosis, including use of intraoperative templates, and to test the accuracy of the results.', 'This is a prospectively analyzed series of retrospective patients with metopic synostosis. Consecutive cases treated by the authors involving a simulated computer-aided planning session were reviewed. Demographic data were tabulated, and three-dimensional quantitative data reviewed. Measurements obtained included bifrontal angle, temporal advancement, and bitemporal distance and widening. Preoperative, simulated, and actual results were compared and analyzed using the t test.', 'Five infants with metopic synostosis treated by this method were included (3 boys, 2 girls). The endocranial bifrontal anglechanged from 111.25° preoperatively to 148.58° postoperatively (P = 0.0001) and simulated 145.62° (compared with actual 148.58) (P = 0.5099). The bitemporal distance preoperative averaged 73.72mm, compared with actual of 89.78mm (P = 0.019), and was simulated to 89.28mm (vs actual 89.78) (P = 0.8815). The surgically planned advancement and expansion were similar compared with actual (P = 0.591, 0.806, and 0.806), respectively.'] Does simulated fronto-orbital advancement achieve reproducible results in metopic synostosis?