title: Cranial vault expansion by distraction osteogenesis.
abstract: OBJECTIVE
  The object of this report is to present a conceptual and technical approach for expanding the cranial vault, by distraction osteogenesis, in patients with craniocephalic disproportion secondary to pancraniosynostosis and in patients with complex syndromic craniofaciosynostoses undergoing operations for aesthetic improvement.
  
  
  METHODS
  The clinical characteristics, techniques used, outcome and complications for all patients who underwent cranial vault expansions with distraction osteogenesis in Children's Hospital of Denver were reviewed.
  
  
  RESULTS
  Twenty-six cranial vault expansions were done in 24 patients. Nineteen patients presented with intracranial hypertension. Twelve of these had pancraniosynostosis and 8 had a syndromic diagnosis. Large segments of cranial bone were translated in a controlled manner for distances up to 30 mm. All but one of the patients with intracranial hypertension experienced complete resolution.
  
  
  CONCLUSIONS
  Cranial vault expansion by distraction osteogenesis has the great advantage, as the name implies, of generating new and vascularized autologous bone of the correct shape and in correct locations. The technique, although not simple and not risk free, is much less technically complicated and places patients at lower risk for the most serious complications than does single-stage vault expansion. Less soft tissue dissection and less devascularization of bone are required and there are no postoperative dead spaces. Distraction osteogenesis facilitates far greater vault expansions than do single-stage procedures and can be accomplished in any desired direction.
authors: Department of Neurosurgery, University of Colorado School of Medicine, Denver, Colorado, USA. winston.ken@tchden.org
authors: Ken R
authors: KR
authors: Winston
authors: Lawrence L
authors: LL
authors: Ketch
authors: Dylaan
authors: D
authors: Dowlati
mesh_terms: D000293:Adolescent; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D002675:Child, Preschool; D003394:Craniofacial Dysostosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D019586:Intracranial Hypertension / Q000601:surgery; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D018570:Risk Assessment; D012886:Skull / Q000254:growth & development / Q000473:pathology* / Q000502:physiology / Q000601:surgery; D013518:Surgery, Plastic / Q000009:adverse effects / Q000379:methods*; D013524:Surgical Flaps; D013580:Synostosis / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult