Expansion of the Posterior Cranial Vault Using Distraction Osteogenesis

Abstract

These preliminary findings indicate that posterior vault distraction is a viable technique with a favorable perioperative profile compared with conventional treatment. Posterior distraction can be the initial strategy with which to address intracranial pressure, allowing delay of definitive frontoorbital advancement until later in childhood.

Outcomes of endoscopic suturectomy with postoperative helmet therapy in bilateral coronal craniosynostosis

“…Other centers have strongly advocated the use of early posterior cranial vault distraction followed by an FOA in bilateral coronal craniosynostosis, and they cite the benefits of early release of cranial restriction and improved morphology due to the cessation of the development of turricephaly. 5,21,24,25,27 Similarly, endoscopic suture release allows safe, early release of restricted cranial growth but addresses the site of pathology directly. This treatment therefore offers the patient the chance of treatment with a single operation and avoids an algorithm that requires 3 operations (osteotomy and device placement, device removal, and ultimate FOA).…”

“…This has resulted in the current practice of early posterior cranial vault distraction, where enlargement of the unaffected posterior vault is used to increase cranial volume early in an attempt to alleviate elevated ICP and the development of turricephaly. 5,21,24,25,27 This procedure is then followed by a delayed frontal advancement.…”

Treatment of Cephalocranial Disproportion in Shunt-Induced Slit Ventricle Syndrome with Cranial Vault Distraction Osteogenesis

“…(4) The dura is kept attached to the bone segments, helping keeping those segments vascularized. This will reduce dead space and improve the healing process [12]. On the other hand, it has the disadvantages of: delaying the final result, requiring an additional procedure for removal of the distractors, and the potential for device-related complications.…”

“…It is a viable technique for achieving expansion without the need for additional bone grafting. Since its first reports, it has been used predominantly for infants with single- and multi-suture synostosis [10,11,12]. …”

“…We used distraction osteogenesis to expand the cranial volume in 2 patients with CCD as a consequence of SVS. Distraction osteogenesis has been described for use in the cranial vault since 2008 [10], and it has been chiefly used in syndromic patients with multi-suture synostosis and patients with single-suture synostosis [10,11,12]. …”