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We demonstrate a novel method of endoscopic frontal-orbital advancement for the treatment of unicoronal craniosynostosis. The evolution of this cranioplasty modality burrows from an established precedent of safety and technical experience in strip craniectomies and endoscopic brow surgery. The procedure facilitates osteotomies similar to open frontal-orbital advancement and uses reabsorbable materials to achieve immediate intraoperative correction of unicoronal craniosynostosis through smaller incisions. The patients in the study underwent endoscopic frontal-orbital advancement and cranial vault remodeling. This was made possible with the use of a novel ultrasonic bone saw that permits osteotomies to be made with minimal disruption to the dura matter. After full frontal-orbital advancement, immediate reabsorbable fixation was used to stabilize the advancement as in the open technique. There were no major complications. All patients demonstrated improvement in plagiocephaly due to unilateral coronal synostosis. Patients and their families reported a 100% patient satisfaction and an improvement in cranial asymmetry from 10 to 2 mm (P < 0.5). This is a new endoscopic cranial vault remolding technique that achieves state-of-the-art correction of unicoronal craniosynostosis with less morbidity and mortality.

Table 1. No statistically significant differences were found between scans evaluated by the 2 investigators about wound area and volume. The relative errors and the intraclass correlation coefficients are reported in Table 2. The ICC values were excellent for both intrarater and interrater reproducibility with a very low relative error value. The mean ± SD time for a full scan acquisition on the wound area and volume was 3.6 ± 1.4 minutes.Comment. The laser scanner system used in this study enables users to accurately acquire 3-dimensional digital models of various types of skin wounds. Since the final users will be physicians and not computer experts, a user-friendly system is believed to be a fundamental parameter for its success.The accuracy of scanning systems has improved in the past few years, and prices have also decreased, making these devices affordable for a wider community of potential users. 6 The integration into a single system of capabilities that can capture the shape and surface reflection characteristics makes 3-dimensional scanning an invaluable resource in all those applications where it is necessary to sample both surface attributes.

LAPD catheter placement is an easy technique with acceptable catheter longevity and minimal morbidity. The microinvasive technique leads to better patient satisfaction and cosmetic outcome without affecting its function. Therefore, we believe that by promoting microinvasive LAPD catheter placement, PD will gain more acceptance among doctors and patients.

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