Cranial compression using distractors in reverse fashion as an alternative method for correcting scaphocephaly in older patients

Pediatr Neurosurg. 2013;49(1):1-10. doi: 10.1159/000354258. Epub 2013 Sep 27.

Abstract

Background: Intraoperative calvarial contraction of conventional calvarial remodeling is more difficult in scaphocephaly patients who are 1 year or older in age. In our current study, gradual cranial compression with a distractor was used to correct scaphocephaly in this older age group and the surgical results were quantitatively analyzed.

Methods: Gradual cranial compression was used to treat 7 sagittal craniosynostosis patients. The mean age was 20.9 months (range, 12-32 months) and the mean follow-up period was 65 months (range, 3-81 months). Computed tomography was used to calculate the cephalic index (CI; equal to the maximum width of the head/maximum length of the head ×100), and the ratios of these indices at 3 different time periods (before, immediately after, and at 1 year postoperatively) were evaluated.

Results: An average cranial compression of 18 mm was found to be possible with an average CI increase from 67.9 to 73.5. The CI ratio at 1 year after surgery was found to be the highest, showing a 9.8% increase.

Conclusion: Sagittal craniosynostosis patients are less easy to treat with conventional calvarial remodeling surgery if they are older than 1 year. Gradual cranial vault compression with distractors can be another option in these cases.

Publication types

  • Clinical Trial

MeSH terms

  • Age Factors
  • Child, Preschool
  • Craniosynostoses / diagnostic imaging
  • Craniosynostoses / surgery*
  • Decompressive Craniectomy / instrumentation*
  • Decompressive Craniectomy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Imaging, Three-Dimensional
  • Infant
  • Male
  • Skull / diagnostic imaging
  • Skull / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome