Treatment of craniosynostosis by distraction osteogenesis.
OBJECTIVE
Craniosynostosis patients treated with one-stage cranioplasty often have bleeding from the dura mater, fluid collection in the extradural space, and poor wound healing due to skin overstretching. To avoid these complications, we began using distraction osteogenesis. To determine the advantages and disadvantages of the procedure, we retrospectively compared distraction osteogenesis with conventional cranioplasty.


RESULTS
We treated 24 patients with fronto-orbital advancement. Fifteen had one-stage cranioplasty; 9 received distraction osteogenesis. The one-stage operation patients averaged 25.5 months of age at surgery, 289 min of operating time, and 154 ml of intraoperative blood loss. For the distraction group, the average age was 16.6 months, average operating time was 196 min, and average blood loss was 76 ml.


CONCLUSIONS
Compared with one-stage cranioplasty patients, distraction osteogenesis patients had significantly less intraoperative bleeding and shorter operating times. The disadvantages of distraction treatment were the need for multiple surgeries, prolonged hospitalization, wound infection, and dislocation of the distraction device.
Akai
Takuya
T
Department of Neurosurgery, Kanazawa Medical University, Ishikawa, Japan. akai@kanazawa-med.ac.jp
Iizuka
Hideaki
H
Kawakami
Shigehiko
S
D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002675:Child, Preschool; D003398:Craniosynostoses / Q000601:surgery*; D003399:Craniotomy; D006801:Humans; D007223:Infant; D007902:Length of Stay; D019857:Osteogenesis, Distraction; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome