Introduction: Lambdoid synostosis can be found unilaterally, bilaterally or in combination with other forms of craniosynostosis. Based on the concept of frontoorbital advancement, we used the occipital advancement in order to correct unilateral or bilateral lambdoid synostosis.
Methods: The standardized technique consists of transverse osteotomies, removal, remodelling and advancement of the occipital region.
Results: Standardized occipital advancement was performed in 21 patients at a multidisciplinary craniofacial centre. The surgery was carried out for patients between 5 and 28 months of age. Aesthetically satisfactory skull shape and normalization of the intracranial pressure could be achieved. A major complication in the form of a life-threatening intraoperative haemorrhage occurred in one case. Other complications like infections have not been experienced.
Conclusion: Standardized occipital advancement allows precise, reproducible and predictable positioning of the segments. Artificial 'sutures' are created as a result of the osteotomy. Remodelling leads to a well-proportioned skull shape and posterior advancement leads to an increase in intracranial volume.
Copyright 2002 Published by Elsevier Science Ltd. On behalf of European Association for Cranio-Maxillofacial Surgery.