La chirurgie du cuir chevelu de l’enfant : principes et particularités thérapeutiques

Long-Term Results in Scalp Tissue Expansion in Children

“…Furthermore, in young boys with a history of male pattern baldness, the expanders should be placed in areas with no androgen receptors (temporal, parietal, and occipital). 12,14 In our study, the child with a poor hairline implantation was the one with burns, a bald patch remains on the left side of his forehead responsible for the irregular hairline implantation. This patient does not wish to undergo further surgery at this time.…”

“…With this technique, the scar is not as wide and is better hidden by the hair. Other authors such as Picard et al 14 or Voulliaume et al 12 also validated the relevance of local reconstruction during closure.…”

“…As previously reported in the literature, these disorders are only temporary and usually resolve spontaneously without any treatment. 4,11,12,[14][15][16] A study recently published by El-Saadi and Nasr 17 on 32 patients aged 2 to 7 years with computed tomography (CT) scan examinations showed the presence of reparative bone remodeling under the tissue expander and spontaneous disappearance of the changes after removing the expanders (control CT scan performed 9 months after the removal of the tissue expanders). An older experimental study by Moelleken et al 18 conducted on miniature pigs validated the presence of osteoclast activity under the tissue expanders causing a periosteal reaction at their periphery.…”

“…The main issues for surgeons are the consequences of tissue expansion on the skull and therefore brain growth of young children. Very few teams 6,14 have used tissue expansion of the scalp in children under the age of 2. In our study, the mean age at the beginning of the protocol, implanting the tissue expanders, was 20 months.…”

Early Surgical Excision of Giant Congenital Hemangiomas of the Scalp in Newborns: Clinical Indications and Reconstructive Aspects

“…Many IHs can be closed by direct approximation within 5 months of age, and only a few cases need flaps. These are easily mobilized, without traction and the risk of necrosis 43,44 (see Figure 8 and Figure 9). Secondary intention healing or skin grafts are potential options to close large scalp defects.…”