Open surgery for the management of isolated craniosynostosis

Craniosynostosis are complex malformations which include a wide range of phenotypes. Craniosynostosis can occur as isolated (scaphocephaly, plagiocephaly, etc.) or associated with polymalformative syndromes (Apert, Crouzon, etc.). In international literature different clinical features are reported, depending on physiopathologic mechanism that involve position of the fetus and/or impaired sutures growth related with molecular alterations. Currently, surgical treatment is the choice for these malformations, although some authors proposed conservative strategies with corrective devices.

Surgery for the correction of craniosynostosis includes a variety of strategies. The aims of surgical treatment can be resumed as follows: (1) correction of deformity with aesthetic and functional restoration; (2) reduction of morbidity and mortality related with surgical intervention; (3) prevention of future neuro-cognitive decline due to continue increased intracranial pressure. Options for surgical intervention range from minimally invasive techniques, such endoscopic strip craniotomies, to open surgery with total vault remodeling.

Strip craniotomies, pioneered by Lane and Lannelogue, were extensively used in the past, but not with satisfactory results, thus leading to the concept that craniosynostosis involve the whole cranium; although strip craniotomies are still practiced in many centers, also with endoscopic technique, in the last years the use of an extensive remodeling is evocated by many authors as the best way to obtain immediate correction of deformities. We report results of our experience with open surgery in a group of patients with craniosynostosis with different features.

Conflict of interest : None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Open surgery for the management of isolated craniosynostosis
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