Acalvaria, also known as acrania, is a rare congenital anomaly which is characterized by a complete or partial defect of the calvarium. Due to the low number of patients reported, there is no a standard for the treatment of this condition; thereby, the objective is to present a new surviving patient with acalvaria and a novel surgical approach to treat it, giving craniofacial surgeons and neurosurgeons more tools to face it. In this article, the authors present a reproducible surgical approach in patients with partial acalvaria, which consist in use the present bone as a graft to cover the defect, giving a temporal but stable coverture. No other calvaria graft has been published along the available literature, since only around 4 patients are acalvaria survivors worldwide. However, the authors need to make a longer follow-up to establish the usefulness of the technique in long term. Other limitation is the future procedures needed to a better function and aesthetic.
Simple craniosynostosis is a cranial deformity that occurs secondary to a premature closure of one or more sutures, with a consequent alteration in cranial growth and cerebral expansion. The cranial alteration presents as flattening parallel to the compromised suture, with compensatory bulging in a perpendicular vector. The surgical treatment consists in cranial decompressions with suturectomies and simultaneous cranioplasties. Dynamic multiple revolution osteotomies allow the design of bone flaps that can help with decompression and correct secondary deformities caused by the synostosis. This multicenter descriptive case series study assessed 52 patients (12 plagiocephaly, 29 scaphocephaly, 7 brachycephaly and 4 trigonocephaly) operated in Cali, Colombia. In each case, suturectomy and telescoping with multiple revolution cranial osteotomies were designed to correct each particular deformity. No clinical complications were observed in the postoperative period (1, 90, and 180 days), and excellent outcomes with no re ossification of sutures and maintenance of the cranioplasty, based on clinical observation and findings in the 3D reconstruction scans.
Simple craniosynostosis is a cranial deformity that occurs secondary to a premature closure of one or more sutures, with a consequent alteration in cranial growth and cerebral expansion. The cranial alteration presents as flattening parallel to the compromised suture, with compensatory bulging in a perpendicular vector. The surgical treatment consists in cranial decompressions with suturectomies and simultaneous cranioplasties. Dynamic multiple revolution osteotomies allow the design of bone flaps that can help with decompression and correct secondary deformities caused by the synostosis. This multicenter descriptive case series study assessed 52 patients (12 plagiocephaly, 29 scaphocephaly, 7 brachycephaly and 4 trigonocephaly) operated in Cali, Colombia. In each case, suturectomy and telescoping with multiple revolution cranial osteotomies were designed to correct each particular deformity. No clinical complications were observed in the postoperative period (1, 90, and 180 days), and excellent outcomes with no re ossification of sutures and maintenance of the cranioplasty, based on clinical observation and findings in the 3D reconstruction scans.
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