| Sagittal
synostosis (scaphocephaly)
If detected early enough, I correct scaphocephaly using a
spring assisted cranioplasty. After 9 months of age a
modified pi-plasty is used.
We have had several cases that have presented at age 5 and
beyond with symptoms of raised intracranial pressure and headaches.
These children have required more extensive calvarial vault
remodeling and have all had excellent improvement in their
symptoms.
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| Metopic
synostosis (trigonocephaly)
Treatment depends on the severity of the deformity. Cases
with a mild metopic ridge can be left. More severe cases have
a triangular forehead, closely spaced eyes and retrusion of
the lateral brow.
Intraoperatively there are often signs of localized raised
intracranial pressure in the lateral forehead region with
very thin indented bone internally.
These cases require frontoorbital
remodeling. Springs have been shown to correct hypotelorism
and we consider their use for cases of very marked hypotelorism.
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References:
Frontobasal suture distraction corrects hypotelorism in metopic
synostosis. C Davis, P Windh, C Lauritzen. Journal
of Craniofacial Surgery 20: 121-4, 2009 |
| Unicoronal
synostosis (plagiocephaly)
Premature fusion of one coronal suture distorts the adjacent
eye socket, forehead and cranial base.
Treatment in each case is individualized and it is very important
to correct both the soft tissue and the bony asymmetry. |
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| Bicoronal
synostosis (Brachycephaly)
Premature fusion of both coronal sutures results in a short
(brachycephalic) head. This may sometimes occur as part of
a syndrome eg Apert syndrome. In less severe cases, such as
that pictured here, we perform a minimally invasive procedure
with spring expansion of both the fused coronal sutures and
the normal lambdoid sutures. In more marked cases we use a
variation of the DCB (Dynamic Cranioplasty for Brachycephaly)
procedure designed in Sweden.
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