Treatment of Scaphocephaly with Sagittal Craniectomy and Biparietal Morcellation

Greene, Clarence S.; Winston, Ken R.

doi:10.1227/00006123-198808000-00012

Cited by 66 publications

(18 citation statements)

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“…Until the late 1960s, the mainstay surgical treatment method for craniosynostosis was suturectomy or placement of foreign materials into the suturectomy site, without effective results, and this lasted for several decades [22,23]. In later years, surgery consisted of various methods of craniotomy and remodeling that are still the most frequently applied technique [10,24,25,26].…”

Section: Discussionmentioning

confidence: 99%

The Trans-Sutural Distraction Osteogenesis for 22 Cases of Craniosynostosis: A New, Easy, Safe, and Efficient Method in Craniosynostosis Surgery

Park

Yoon

2011

Pediatr Neurosurg

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Background: Distraction osteogenesis for the treatment of craniosynostosis is becoming more widely used as it is simple, there are less transfusions, and a decreased incidence of complications, although a secondary procedure for the removal of the distractors is necessary. However, to date all previous procedures have still been complicated. The authors present a novel trans-sutural distraction osteogenesis method (TSuDO) for the treatment of all types of craniosynostosis. Methods: The TSuDO consisted of simple suturectomy of the pathologic suture followed by direct distraction of the suturectomy site only. Types of TSuDO conducted were sagittal TSuDO in 6 patients, coronal TSuDO in 5 patients, unilateral coronal TSuDO in 8 patients, lambdoid TSuDO in 2 patients, and metopic TSuDO in 1 patient (total = 22). Mean age was 9.3 ± 12.7 months. Results: The mean operation time was 143.6 ± 50.2 min, and mean total transfusion volume of blood components was 131.1 ± 78.3 ml. Immediate correction of the abnormal head contour after distraction was observed in all patients, and no complications were encountered except for 1 patient whose distractor malfunctioned and 2 who showed prolonged discharges from the pin sites (controlled by antibiotics). Conclusion: TSuDO is a simple, effective, and safe method for the treatment of all types of craniosynostosis, and is especially effective for the correction of unilateral coronal craniosynostosis.

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Section: Discussionmentioning

confidence: 99%

The Trans-Sutural Distraction Osteogenesis for 22 Cases of Craniosynostosis: A New, Easy, Safe, and Efficient Method in Craniosynostosis Surgery

Park

Yoon

2011

Pediatr Neurosurg

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“…3,5,[9][10][11][12]15,17,[20][21][22][23][26][27][28][29][30][31][33][34][35][36]38,40,[43][44][45][46][47][48][49][50][51] The field continues to evolve and aims to reduce the impact of surgery. Minimally invasive approaches constitute the majority of recently detailed techniques.…”

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confidence: 99%

Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome

Veelen¹,

Mihajlović²,

Dammers³

et al. 2015

PED

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OBJECT Various techniques to correct sagittal synostosis have been described. The authors of this study assess the results of 2 techniques for late complete cranial remodeling and test the hypothesis that adding a widening bridge would improve outcome. METHODS In this retrospective study, the authors evaluated patients with nonsyndromic sagittal synostosis—those who underwent frontobiparietal remodeling (FBR) and those who underwent modified FBR (MFBR) involving the introduction of a bony bridge to increase the width of the skull. Outcomes for both groups are described in terms of the aesthetic results assessed on photographs and any changes in the cranial index (CI) and head circumference over time, the presence of papilledema, and complaints of headache. The effect of the surgical technique on CI and head circumference over time was assessed using linear regression analysis, with adjustment for preoperative CI and head circumference. RESULTS Sixty-nine patients with isolated sagittal synostosis were included in this study: 35 underwent MFBR and 34 underwent the original technique of FBR. The mean follow-up period was 7 years. In the 1st year after surgery, mean CI improved by 9% in the FBR group and by 12% in the MFBR group. One year after surgery, CI in the MFBR group was on average 4.7% higher than that in the FBR group (p < 0.001). During follow-up, CI decreased in both groups; however, at all time points CI was significantly higher in the MFBR group than in the FBR group. The impact of surgical technique on CI was less important than the impact of preoperative CI (R2= 0.26 vs 0.54), and this applied at all time points during follow-up. Head circumference declined during follow-up in both groups. It was influenced by preoperative head circumference, but not by surgical technique. Aesthetic outcome, prevalence of headache (42%), and papilledema (7%) were comparable in both groups. CONCLUSIONS Adding a widening bridge to late complete remodeling significantly improved CI and helped to prevent CI from decreasing in the long term. This addition did not affect the head circumference growth curve. Despite a mean head circumference remaining at +1 SD, patients continued to develop papilledema postoperatively (7%).

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“…There could also be a high incidence of anxiety among the parent and children. There are many reports where parents show their regret for not having authorized treatment 3,11 . In these series, parents were invariably pleased with the surgical results.…”

Section: Discussionmentioning

confidence: 99%

“…It is already universally accepted that children having such a deformity should be treated early by surgical correction. The most used surgical techniques are the linear craniectomy with placemení of interpositional material (polyethylene, silastic) 7,25 and the wide vertex craniectomy 8,11,12,21,28,29 . Some surgeons use wire to reduce the length of me skull 1,15,30 or multiple cauterization of tiie diira mater 4 or else the treatment of the dura mater with Zenker solution 2,22 .…”

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confidence: 99%

Tratamento cirúrgico das patologias vasculares cerebrais nos pacientes epilépticos

Rassi-Neto

Ribeiro

Prates

et al. 1997

Arq. Neuro-Psiquiatr.

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-A series of 50 consecutive children with premature sagittal synostosis is reported. All were treated surgically; 43 were male, 47 were leukodermic and two are siblings. In the pre-operative examination, the head shape, skull measurements and radiologic findings were evaluated; 38 children were operated on before six months of age and 12 of them, between six and 12 months of age. The surgical technique used was a wide biparietal craniectomy. Blood transfusions were occasional, being necessary for only six (12%) children. The children were admitted at the day of surgery and discharged between the second and the third post-operative day. No local or general complications were observed and no one died. The aesthetic result was considered good. The altered skull measurements before surgery reached normalization as far as the end of the first year after the treatment. It may be concluded that wide biparietal craniectomy is a procedure of great effectiveness in the treatment of the premature fusion of the sagittal suture.KEY WORDS: craniosynostosis, sagittal suture.Tratamento cirúrgico da fusão prematura da sutura sagital RESUMO -É apresentada uma série de 50 crianças com fusão isolada e prematura da sutura sagital, tratadas cirurgicamente; 43 eram do sexo masculino, 47 leucodérmicas e duas irmãs. No pré-operatório foram avaliados o formato da cabeça, medidas do crânio e medidas radiológicas, 38 crianças foram operadas antes dos 6 meses de idade e 12 entre os 6 e 12 meses. A técnica cirúrgica usada foi a craniectomia parcial, ampla e biparietal. A transfusão sanguínea foi eventual, sendo necessária em somente 6 crianças (12%). As crianças foram admitidas no dia da cirurgia e receberam alta entre o segundo e terceiro dia após a cirurgia. Não foram observadas complicações locais ou gerais e não houve óbito. O resultado estético final foi considerado bom; as medidas do crânio, alteradas antes da cirurgia, se normalizaram até um ano após o tratamento. Conclui-se que a craniectomia parcial, ampla e biparietal é eficiente no tratamento da fusão isolada e prematura da sutura sagital, até o primeiro ano de vida. PALAVRAS-CHAVE: craniossinostose, sutura sagital.The first papers concerning the surgical treatment, of premature craniosynostosis were already published in the last century 17,18 . Nevertheless, as recently as the middle of the twentieth century, the surgical treatment of the premature fusion of the sagittal suture faced a strong resistance among experts. Since Faber and Towne (1943) 9 , Simmons and Peyton (1947) 26 , Ingraham and cols. (1948) 14 many techniques have been proposed for the surgical correction of this malformation. It is already universally accepted that children having such a deformity should be treated early by surgical correction. The most used surgical techniques are the linear craniectomy with placemení of interpositional material (polyethylene, silastic) 7,25 and the wide vertex craniectomy 8,11,12,21,28,29 . Some surgeons use wire to reduce the length of me skull 1,15,30 or multipl...

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Treatment of Scaphocephaly with Sagittal Craniectomy and Biparietal Morcellation

Cited by 66 publications

References 0 publications

The Trans-Sutural Distraction Osteogenesis for 22 Cases of Craniosynostosis: A New, Easy, Safe, and Efficient Method in Craniosynostosis Surgery

The Trans-Sutural Distraction Osteogenesis for 22 Cases of Craniosynostosis: A New, Easy, Safe, and Efficient Method in Craniosynostosis Surgery

Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome

Tratamento cirúrgico das patologias vasculares cerebrais nos pacientes epilépticos

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