title: Dynamic total skull remodeling by a combination of morcellation craniotomy with distraction osteogenesis: the MoD procedure.
abstract: There are no procedures available to reconstruct the normal cranial shape irrespective of the type of cranial deformity with minimal patient stress and morbidity. To achieve dynamic total skull remodeling, we considered a new remodeling concept and developed a new procedure by combining morcellation craniotomy and distraction osteogenesis, termed the MoD procedure, and designed a distraction device, namely the angle variable distraction (AVD) system. Between 2000 and 2009, we treated 41 patients with craniosynostosis (28 and 13 cases of isolated and syndromic craniosynostosis, respectively) by using the MoD procedure with the AVD system. Compared with the conventional methods, the mean operative time was significantly shorter, and the mean transfusion volume was significantly less for the MoD procedure. In all the patients, good cranial shape and adequate cranial volume were achieved without serious complications. In conclusion, the MoD procedure with the AVD system is safe, effective, and reliable for dynamic total skull remodeling with minimal morbidity. It could be used to improve the previous surgical concepts for treating craniosynostosis.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan. nakajiprs@yahoo.co.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Nakajima
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Ikkei
authors.initials: I
authors.lastname: Tamada
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ohara
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kishi
mesh_terms: D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D003398:Craniosynostoses / Q000145:classification / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D004867:Equipment Design; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007427:Intracranial Pressure; D007902:Length of Stay; D008297:Male; D009777:Occipital Bone / Q000601:surgery; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D010294:Parietal Bone / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012449:Safety; D012886:Skull / Q000254:growth & development / Q000601:surgery; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome