Multiple osteotomies with combined distraction osteogenesis for non-syndromic scaphocephaly
10.3760/cma.j.issn.1009-4598.2019.02.002
- VernacularTitle: 多块颅骨截骨加联合牵张成骨术治疗非综合征型舟状头畸形
- Author:
Qingwen GAO
1
;
Yi JI
;
Jie CUI
;
Jianbing CHEN
;
Weimin SHEN
Author Information
1. Department of Burn and Plastic Surgery, Children′s Hospital of Nanjing Medical University, Nanjing 210008, China
- Publication Type:Clinical Trail
- Keywords:
Osteogenesis, distraction;
Sagittal suture;
Craniosynostosis;
Scaphocephaly;
Combined distraction
- From:
Chinese Journal of Plastic Surgery
2019;35(2):105-111
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical effect of multiple osteotomies combined with distraction osteogenesis in the treatment of non-syndromic scaphocephaly infants and young children.
Methods:Clinical records of 8 non-syndromic scaphocephaly patients, during January 2017 to October 2018, from the Department of Burn and Plastic Surgery, Children′s Hospital of Nanjing Medical University, were retrospectively analyzed. There were 3 males and 5 females, aged from 3 to 28 months, with an average of 13 months. Among them, 4 cases were typical scaphocephaly, 2 cases were anterior scaphocephaly and 2 cases were posterior scaphocephaly. According to the subtypes of scaphocephaly, different osteotomy methods and distraction directions were designed. The cranial vault was osteotomized by piezosurgery osteotomy in a multiple way. The dura did not separate from cranial flap. The internal distractors were installed subsequently. After a mean latency period of 5 days, the devices were activated at a rate of 0.4-0.6 mm/d. Distractor was extended twice a day. After 10-15 days activation period and 6 months consolidation, all the distractors were removed. Three-dimensional CT scans were performed before and after operation to measure the anteroposterior and bitemporal diameters, so as to calculate the cranial index.
Results:Follow-up ranged from 6 to 14 months (average, 10 months). The average anteroposterior length of 8 children was(158.2±12.9) mm before operation, and (145.5±14.2) mm after operation, which was shortened(12.6±3.4) mm. Bitemporal diameters was(99.6±8.6) mm preoperatively and(113.9±7.5) mm postoperatively, which was widened (14.2±2.8) mm. Preoperative and postoperative cranial index was 63.2 and 78.3, respectively. The scaphocephalic head shape was significantly improved in all patients. There was no serious complications such as skull necrosis or intracranial infection.
Conclusions:Different types of multiple osteotomy combined with distraction osteogenesis are useful to correct various scaphocephaly of infants and children, by improving skull shape and cranial index.
