Experience with intracranial volume increase in craniosynostosis using posterior cranial vault distraction osteogenesis

Aim: To study distraction osteogenesis of the posterior cranial vault in children requiring increased intracranial volume.

Materials and methods: Ten patients were treated with cranial distractors. Five children had previously been operated for scaphocephaly and one child for Saether Chotzen syndrome. Two patients had bilateral coronal suture synostosis with Muenke syndrome and two patients had Apert syndrome. At surgery cranial bones were mobilized, the head was widened during surgery, and the segments fixed to each other with distarctors. Further expansion at a rate of 1 mm/day was performed over 2–4 weeks. The cranium was distracted posteriorly from 20 to 30 mm.

Results: Patients all tolerated surgery and distraction well and parents were able to perform the distraction at home. There were no technical problems with the distraction devices. Two cases had minor cutaneous problems, where the distractor penetrated the skin. These cases responded to gentle local wound care measures. At the time of distractor removal, ossification had occurred sufficiently in one of these two cases. In the other case the device was removed and replaced with a resorbable plate, without any harmful effect on the result. In all cases sufficient expansion was achieved without causing more cosmetic deformity. Ossification occurred in all cases. This method seems effective, as the calculated increase in intracranial volume was a mean of 21.2% (range 7.3–37%).

Conclusions: This preliminary series shows that cranial bone distraction is a useful method for cranial expansion with low morbidity in children with craniosynostosis.

Conflict of interest: No conflicts of interest exist for any of the authors.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Experience with intracranial volume increase in craniosynostosis using posterior cranial vault distraction osteogenesis
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