Preliminary results of standardized occipital advancement in the treatment of lambdoid synostosis.
BACKGROUND
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.


CONCLUSIONS
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.
Zöller
Joachim E
JE
Department of Oral and Maxillofacial Surgery, Medical Centre, University of Cologne, Köln, Germany.
Mischkowski
Robert A
RA
Speder
Bernhard
B
D016063:Blood Loss, Surgical; D002657:Child Development; D002675:Child, Preschool; D003393:Cranial Sutures / Q000002:abnormalities / Q000601:surgery*; D003398:Craniosynostoses / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007427:Intracranial Pressure; D008297:Male; D009777:Occipital Bone / Q000002:abnormalities / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D010294:Parietal Bone / Q000002:abnormalities / Q000601:surgery*; D011597:Psychomotor Performance; D015203:Reproducibility of Results; D012886:Skull / Q000033:anatomy & histology