medigraphic.com
ISSN 2992-8559 (Electronic)
ISSN 1405-0625 (Print)

2015, Number 2

<< Back Next >>

Cir Plast 2015; 25 (2)

Early and late alternatives of surgical management of scaphocephaly

Gordillo DLF, Andrade DL, Gordillo ALF

Language: Spanish
References: 19
Page: 56-66
PDF size: 512.86 Kb.


ABSTRACT

Scaphocephaly is the premature fusion of the sagittal suture, causing an ovoid-shaped cranial dysmorphia. This closure causes varying degrees of brain compression, intracranial hypertension, and psychoneurodevelopment deterioration of the child. Cranial deformities can be identified from birth; therefore, the diagnosis should be confirmed early on. The study of choice is a skull computed scan tomography with a three-dimensional reconstruction. Surgical treatment of this craniostenosis should be performed at the time of diagnosis and preferably that procedure should be carried out before the patient is six months old. We applied the technique of sagittal suturectomy with craniectomy parallel to coronal and lambdoid sutures, a technique known as «bear skin» that includes the dural devitalization through the dural sagittal parasinusal bilateral coagulation to form neo sutures obtaining the right remodeling, preserving the ability of osteogenesis of the skull and the rest of the cranial suture complex. The technique used in later stages consists of increasing the biparietal diameter through the bone transposition, adding radiated rising sun osteotomies in the front region or an asterisk in the transposed parietal bones to avoid leaving bone defects, as well as to reduce transoperative blood loss by limiting exposure to the superior sagittal sinus. Changes in the surgical technique are presented, with zigzag bicoronal incision and the osteotomies referred, which give better aesthetic and functional results.


REFERENCES

  1. Posnick JC. Scaphocephaly: sagittal synostosis. In: Posnick JC, editors. Craniofacial and maxillofacial surgery in children and young adult. Volume One. Philadelphia: WB Saunders; 2000: pp. 199-230.

  2. Reinier AD, Marchac AD. Classification des craniosténoses. Neurochirurgie 2006; 52(2-3): 200-227.

  3. Chico F. Craneoestenosis I. Bases biológicas y análisis de las craneoestenosis no sindromáticas. Bol Med Hosp Inf Mex 2011; 68(5): 333-348.

  4. Andrade DRA. Craneosinostosis metópica (trigonocefalia). Resultados quirúrgicos de pacientes tratados en el Instituto Nacional de Pediatría (periodo 2002-2011). Archivos de Neurociencias 2013; 18 (2 supl esp).

  5. Andrade DRA, García S, Morel-Trejo C, Valdez-Orduño R. Craneosinostosis: casuística del 2005 al 2010 y resultados quirúrgicos de pacientes manejados en CMN “20 de Noviembre” ISSSTE. Archivos de Neurociencias 2013; 18 (3 supl esp).

  6. Renier D, Le Merrer M, Arnaud E, Marchac D. Étiologie des craniosténoses. Neurochirurgie 2006; 52(2-3): 228-237.

  7. Renier AD, Marchac AD. Les craniosténoses: physiopathologie. Neurochirurgie 2006; 52(2-3): 195-199.

  8. Renier AD, Marchac AD. Le retentissement fonctionnel des craniosténoses. Neurochirurgie 2006; 52: 259-263.

  9. Sgouros S, Goldin JH, Hockley AD, Wake MJC, Nataranjan K. Intracranial volume change in childhood. J Neurosurg 1999; 91: 610-616.

  10. Renier D, Capon-Degardin N, Arnaud E, Marchac D. Diagnostic des craniosténoses. Neurochirurgie 2006; 52: 238-245.

  11. Tessier P. Ostéotomies totales de la face. Syndrome de Crouzon. Syndrome d’Apert. Oxycéphalie. Scaphocéphalies. Turricéphalies. Ann Chir Plast 1967; 12: 273-285.

  12. Marchac D, Cophignon J, Van Der Meulen J, Bouchta M. À propos des ostéotomies d’avancement du crâne et de la face. Ann Chir Plast 1974; 19: 311-323.

  13. Marchac AD, Renier AD. Le traitement fonctionnel des craniosténoses: indication et techniques. Neurochirurgie 2006; 52: 264-291.

  14. Dhellemmes P, Pellerin P, Vinchon M, Capon N. Quand et comment faut-il opérer une craniosténose? Ann Fr Anesth Reanim 2002; 21: 103-110.

  15. Ortiz-Monasterio F, Fuente del Campo A, Carrillo A. Advancement of the orbits and the midface in one piece, combined with frontal repositioning, for correction of Crouzon’s deformity. Plast Reconstr Surg 1978; 61: 501-516.

  16. Fuentes MA, Gordillo DLF, Chico PF. Transposición biparietal en el tratamiento quirúrgico de pacientes con escafocefalia tardía, en niños mayores de 2 anos. Déficit presente en ellos y experiencia del Hospital Infantil de México Federico Gómez de enero 2003 a abril 2014 [Tesis para obtener el título de especialista en Neurocirugía Pediátrica]. México: Universidad Nacional Autónoma de México; 2015.

  17. Ciurea AV, Toader C, Mihalache. Actual concepts in scaphocephaly (an experience of 98 cases). J Med Life 2011; 4(4): 424-431.

  18. Kuang AA, Selden NRB. Secondary cranial vault remodeling for restenosis after primary sagittal synostosis repair. Ped Neurosurg 2014; 50: 104-108.

  19. Hashim PW, Patel A, Yang JF, Travieso R, Terner J, Losee JE et al. The effects of whole-vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal craniosynostosis. Plast Reconstr Surg 2014; 134(3): 491-501.




2020     |     www.medigraphic.com