Background. The aim of the study was to review the methods of diagnosis of craniosynostosis and to analyze Vilnius (Lithuania) team experience of surgical treatment, surgical methods, aspects of anesthesia for patients with craniosynostosis and to present early results of surgical treatment.Materials and methods. A retrospective review of all patients with various types of craniosynostosis treated surgically during the period from 1 January 2009 to 31 December 2014 was performed. The following data were analyzed: age, type of deformity, surgical technique, surgical time, methods and course of anesthesia, intra-and postoperative complications, parents' satisfaction, head form.Results. 24 patients were treated. The mean patient's age at the time of surgery was 13.47 ± 8.2 months (min 7.3, max 46.5). Eliminating 3 patients whose age at the time of surgery was over 2 years (24.5, 29 and 46 months, respectively), the mean age of other 21 patients was 10.63 ± 1.77 (min 7.3, max 14.1) months. There were 9 cases of isolated trigonocephaly (37.5%), 7 cases of isolated scaphocephaly (29.2%), 7 cases of isolated anterior plagiocephaly (29.2%) and 1 case of posterior plagiocephaly combined with scaphocephaly (4.17%). All craniosynostoses were diagnosed clinically and diagnosis was confirmed with computed tomographic scanning. The median duration of surgery was 336.47 ± 59.63 minutes (min 308.13, max 364.82). The medium stay in the intensive care unit was 2.53 ± 1.28 days (min. 1.92, max 3.14). In all cases rigid osteosynthesis was performed. 2 children were diagnosed with syndromic craniofacial abnormalities. In 23 (95.83%) cases an intraoperative or postoperative blood transfusion was required. In 24 treated patients there was no mortality. During the early and late postoperative period no infections, CSF leakage and dural tears were observed. No neurological impairments or any signs of neurological deficits were observed by any of the treated patients. In all of cases parents were satisfied with their children's changed head shape and aesthetic results.Conclusions. Cranioplasties for correction of craniosynostosis give good aesthetic results and this is a safe method, which helps to correct the head shape as well as improves the social adaptation of patients.

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Atlikta analizė 555 vaikų galvos kompiuterinės tomografijos tyrimų, atliktų 2012 metais Vaikų ligoninėje, Vilniaus universiteto ligoninės Santariškių klinikų filiale, dėl neurologinių simptomų. Pacientai buvo suskirstyti į 4 amžiaus grupes bei išskirtos 5 pagrindinės klinikinės indikacijos esant neurologiniams simptomams. Lyginant gautos apšvitos parametrus ir rastų pakitimų rezultatus, statistiškai įvertintas tyrimų pagrįstumas. Daugiausia pakitimų rasta 0–5 metų amžiaus grupėje (32,4– 100 proc.). Mažiausiai pakitimų rasta siunčiant tyrimui dėl intrakranijinės hipertenzijos (15 proc.) ir po traukulių (20 proc.). Pacientų, kuriems buvo atliktas galvos kompiuterinės tomografijos tyrimas, gautos vidutinės apšvitos dozių vertės neviršijo rekomenduojamų apšvitos lygių. Įvertinta vidutinė KT tyrimo metu gauta efektinė dozė buvo nuo 4,7 iki 2,0 mSv. Išvados. Esant vaikų neurologiniams simptomams ir atlikus galvos kompiuterinės tomografijos tyrimą, 25 proc. visų atvejų buvo rasta pakitimų. Dėl jonizuojančiosios spinduliuotės poveikio ir vėžio ligų rizikos vaikams svarbu įvertinti vaikų kompiuterinės tomografijos tyrimų pagrįstumą ir indikacijų svarbą.

Background. The aim of this article is to present rare clinical cases of craniofacial fibro-osseous lesions in pediatric patients. Materials and methods. In this report we present 3 cases of fibroosseous craniofacial lesions in pediatric patients. Lesions of bones resembled fibrous dysplasia, dysplastic fibroma and chronic osteomyelitis which were confirmed or suspected by clinical signs, radiographic visualization methods and histopathological investigations for these patients. The diagnostic workup, treatment, follow-up procedures and a literature review are presented. Results and conclusions. Fibro-osseous lesions of the jaws and skull manifest in a similar pattern. Conditions are easily revealed upon examination and with the help of conventional diagnostics, however, differential diagnosis using only radiological imaging is impossible. Histological findings remain a tool of choice determining the treatment strategy and outcome of the patients but it is not always available due to anatomical and functional considerations. Treatment of fibro-osseous lesions of the face and skull is highly individualized and depends on various qualities of the lesion and the patient himself. All patients received palliative symptomatic treatment to alleviate their conditions and in all cases obtaining a histology specimen and surgical intervention for treatment of the lesion was considered as a treatment option only if it was seen being safe and as least traumatic as possible because of the functional and psychological importance of the craniofacial region.