Increases in Cranial Volume with Posterior Cranial Vault Distraction in 31 Consecutive Cases

Salokorpi, Niina; Vuollo, Ville; Sinikumpu, Juha‐Jaakko; Satanin, Leonid; Zibo, Heleia Nestal; Ylikontiola, Leena P.; Pirttiniemi, Pertti; Sándor, George K.B.; Serlo, Willy

doi:10.1093/neuros/nyx125

Cited by 31 publications

(39 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, volume expansion in open cranial vault remodeling is more immediate but is limited in extent by these forces at the time of closing. Posterior vault DO can achieve 10% to 34% of steady post-operative increase in total intracranial volume [13][14][15]. In this patient, we achieved a posterior fossa volume increase of 15.9% from distraction forces alone.…”

Section: Discussionmentioning

confidence: 64%

Management of Pre-existing Ventriculoperitoneal Shunt in Posterior Vault Distraction for Lambdoid Craniosynostosis: A Case Report and Technical Note

Pearson¹,

Thatikunta²,

Nuru³

et al. 2021

Cureus

View full text Add to dashboard Cite

Posterior vault distraction osteogenesis (DO) is an emerging treatment option for craniosynostosis. Operative nuances detailing surgical management are being described with increasing use and experience. In this article, we discuss the surgical management of an 8-month-old male with a ventriculoperitoneal shunt (VPS) diagnosed with bilateral lambdoid craniosynostosis and Chiari I malformation. The patient underwent successful bilateral posterior fossa DO without surgical re-implantation of the shunt. Pre- and post-operative imaging confirmed no migration of the VPS. Intracranial volume increased by 20.1% and posterior fossa volume increased by 39.9%. Our experience illustrates that posterior vault DO can be done safely in the setting of a parieto-occipital VPS, in a single operative setting, without the need of additional procedures.

show abstract

Section: Discussionmentioning

confidence: 64%

Management of Pre-existing Ventriculoperitoneal Shunt in Posterior Vault Distraction for Lambdoid Craniosynostosis: A Case Report and Technical Note

Pearson¹,

Thatikunta²,

Nuru³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…PCVD is an effective method widely used in the treatment of various forms of craniofacial diseases associated with significant craniocerebral disproportion [4,[13][14][15][16]. Despite many advantages to this method, the main drawback is the need for a secondary operation to remove devices.…”

Section: Discussionmentioning

confidence: 99%

Experience with resorbable sonic pins for the attachment of distraction devices in posterior cranial vault distraction operations

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background Distraction techniques are effective methods for the treatment of craniosynostoses when a significant gain of an intracranial volume is required. However, this technique raises some challenges at different stages of the treatment. While installing the distractors in patients with thin calvarial bone, there is a risk of dural damage from the titanium screws. The need for wide exposure of the devices and the screws during removal causes soft tissue damage and bleeding. Objective This study aimed to evaluate sonic pin use in the distraction procedures. Methods Resorbable sonic pins were used in 11 consecutive posterior cranial vault distraction procedures to attach distraction devices to the calvarial bone. Results This method allowed for a less traumatic and faster removal of the devices without the risk of leaving foreign bodies in the wound. In three out of 11 cases on follow-up, displacement of proximal distractor footplate and partial relapse of distraction were detected. Though there was a smaller volume increase in these patients, all of them benefited clinically from the PCVD and did not require reoperations. Conclusions This method allows a strong and stable attachment of the distractor devices to the cranial vault bones with a reduced risk of dural tears due to the screws. It also allows for easier and less traumatic device removal.

show abstract

“…Increased ICP with orbital proptosis might require fronto-orbital advancement with or without cranioplasty, and increased ICP in the presence of orbital proptosis and hypoplastic maxilla might require a monobloc as practiced in the authors' center. Surgery can be performed conventionally or combined with distraction osteogenesis (DO) technique, which is indicated for superior structural expansion and achieving simultaneous new histogenesis compared with conventional surgical procedures [28]. The application of DO in treating craniofacial deformity was first reported in 1992 [29].…”

Section: Fronto Orbital Advancement and Monobloc Le Fort III Advancementmentioning

confidence: 99%

“…Metal fixation carry a possibility of intracranial fixation due to appositional cranial growth. Some reported translocation of hardware into calvarial bone in 14% and 6.6% with intracranial translocation and commonly occur in younger and syndromic patients [28]. Therefore, usage of resorbable hardware has now become more popular due to concerns about constriction of growth by metal fixation and the possibility of implant translocation [29][30][31][32].…”

Section: Mortality and Morbidity Rate Following Craniofacial Surgicalmentioning

confidence: 99%

“…Since 1970's to 1988, rate of mortality in craniofacial surgery were reported ranging from 1 to 2% all over the world [47][48][49][50][51]. However, with development of the technology, deeper understanding of the craniofacial surgery and its risks with emphasis on multidisciplinary approach, the numbers of mortality have dropped to 0.1-0.8% in some centers [24][25][26][27][28][29].…”

Section: Mortality and Morbidity Rate Following Craniofacial Surgicalmentioning

confidence: 99%

See 1 more Smart Citation

Craniofacial Corrective Surgery in Syndromic Craniosynostosis

Adam¹,

Hariri²,

Chee³

et al. 2021

Spina Bifida and Craniosynostosis - New Perspectives and Clinical Applications

View full text Add to dashboard Cite

This surgical field has now progressed and becoming an established subspecialty involving various surgical disciplines worldwide. Various complex CMF syndromes reported in syndromic craniosynostosis include Crouzon, Apert and Pfeiffer syndromes. These syndromes carry specific functional discrepancies associated with the affected structural anomaly and may therefore have functional issues involving the brain, eye and airway among others. As corrective surgery is often indicated depending on the affected vital functions, other factors that need to be considered are patient’s age, comorbidities, urgency, available expertise and patient’s overall prognosis based on the degree of anomaly. As such, the corrective surgery can be categorized into; (1) intermediate which is performed at an early phase and aimed to improve or salvage important vital functions such as the brain, eye, airway or feeding which are important for the child’s development and, (2) definitive treatment aimed at permanently correct the functional discrepancies. Intermediate corrective surgery may include invasive procedures such as ventriculo-peritoneal (VP) shunts, tarsorrhaphy, adenotonsillectomy and tracheostomy whereas definitive corrective surgery may include surgical procedures such as monobloc, Le Fort III osteotomy, posterior cranial vault expansion and mandibular advancement. This chapter will elaborate on the indications, types, challenges in the management and the proposed prevention measures in corrective surgery for specifically for syndromic craniosynostosis patients.

show abstract

Increases in Cranial Volume with Posterior Cranial Vault Distraction in 31 Consecutive Cases

Abstract: PCVD is an effective surgical method to increase intracranial volume in a variety of clinical entities. Volumetric results of this procedure could be easily evaluated using 3-D photogrammetric imaging or plane radiographs that expose the patients to only low ionizing radiation doses.

Cited by 31 publications

References 20 publications

Management of Pre-existing Ventriculoperitoneal Shunt in Posterior Vault Distraction for Lambdoid Craniosynostosis: A Case Report and Technical Note

Management of Pre-existing Ventriculoperitoneal Shunt in Posterior Vault Distraction for Lambdoid Craniosynostosis: A Case Report and Technical Note

Experience with resorbable sonic pins for the attachment of distraction devices in posterior cranial vault distraction operations

Craniofacial Corrective Surgery in Syndromic Craniosynostosis

Contact Info

Product

Resources

About