Surgical correction of scaphocephaly: experiences with a new procedure and follow-up investigations.
BACKGROUND
Simple resection of the sagittal suture and the use of alloplastic material or extensive skull resections have long been proven to be unsatisfactory in the treatment of sagittal synostosis. In contrast to these experiences, the immediate correction of skull shape seems to yield the best results without significant morbidity.


METHODS
Thirty-six scaphocephalic infants with an average age of 6.5 (3.5-14) months underwent operation by our craniofacial team since 1994.


METHODS
Wide resection of the sagittal suture was used in combination with a bone-strip resection along the coronal and lambdoid sutures. Occasionally partial resection and reshaping of the frontal or occipital bone was necessary to correct an extremely bulging skull. The cranial growth and shape was monitored by anthropometric skull measurements in the last 20 patients.


RESULTS
Except in two cases, in which the dura mater was minimally injured intraoperatively, no complications occurred in any patient. Craniofacial oedema always occurred but disappeared after 72 h. The immediate correction of the skull shape was successful in all cases and was completed within 6 months postoperatively. There was no iatrogenic bone defect one year after surgery. Postoperative skull shape and growth was normal.


CONCLUSIONS
These procedures seem to be effective in the treatment of scaphocephalus. Further normalization of skull shape is achieved by unrestricted postoperative brain growth.
Christophis
P
P
Department of Neurosurgery, Medical School, Justus Liebig-University Giessen, Germany. petros.christophis@neuro.med.uni-giessen.de
Jünger
T H
TH
Howaldt
H P
HP
D002508:Cephalometry; D003393:Cranial Sutures / Q000002:abnormalities*; D003398:Craniosynostoses / Q000601:surgery*; D003399:Craniotomy / Q000009:adverse effects / Q000379:methods; D004210:Dissection; D004388:Dura Mater / Q000293:injuries; D004487:Edema / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005624:Frontal Bone / Q000254:growth & development / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease; D007223:Infant; D007431:Intraoperative Complications; D008297:Male; D009777:Occipital Bone / Q000254:growth & development / Q000601:surgery; D010294:Parietal Bone / Q000002:abnormalities* / Q000254:growth & development; D010521:Periosteum / Q000601:surgery; D011183:Postoperative Complications; D012886:Skull / Q000254:growth & development / Q000473:pathology; D013701:Temporal Bone / Q000601:surgery; D013997:Time Factors