The role of distraction osteogenesis in children with secondary craniosynostosis after shunt operation in early infancy.
BACKGROUND
Secondary craniosynostosis rarely develops within several months in infants or children after shunt operations in early infancy. However, conventional operations (CO) such as fronto-orbital advancement and total skull reshaping have not been efficient enough to expand the intracranial volume in children with secondary craniosynostosis. Recently, distraction osteogenesis (DO) was reported to be effective in treating most craniosynostosis cases.


METHODS
We compared 9 children treated with DO and 3 children treated with CO who developed secondary craniosynostosis after shunt operation in early infancy. We measured the preoperative and follow-up head sizes with regard to head circumference, cephalometric intracranial volume, and intracranial volume estimated from the 3-dimensional computed tomogram.


RESULTS
The mean intracranial volumes expanded by 10.5% in the DO group 1 month after surgery and by 13.1% in the CO group on the immediate postoperative day. Further expansion was observed 6 months postoperatively, i.e. 10.3 and 4.7% in the DO and CO groups, respectively. Operation time and anesthesia time were significantly shorter in DO compared to CO patients, and the volumes of the blood transfusions were also less for DO patients.


CONCLUSIONS
We suggest that DO is probably more efficient and safer than CO in expanding the intracranial volume in children with secondary craniosynostosis.
Park
Dong Ha
DH
Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon 443-721, Korea.
Chung
Jaiho
J
Yoon
Soo Han
SH
D001860:Bone Plates; D001863:Bone Screws; D002508:Cephalometry / Q000379:methods*; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects* / Q000379:methods; D015331:Cohort Studies; D003398:Craniosynostoses / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005624:Frontal Bone / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009421:Nervous System Malformations / Q000175:diagnosis / Q000601:surgery; D019857:Osteogenesis, Distraction / Q000379:methods*; D011336:Probability; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome