Cranial compression using distractors in reverse fashion as an alternative method for correcting scaphocephaly in older patients.
BACKGROUND
Intraoperative calvarial contraction of conventional calvarial remodeling is more difficult in scaphocephaly patients who are 1 year or older in age. In our current study, gradual cranial compression with a distractor was used to correct scaphocephaly in this older age group and the surgical results were quantitatively analyzed.


METHODS
Gradual cranial compression was used to treat 7 sagittal craniosynostosis patients. The mean age was 20.9 months (range, 12-32 months) and the mean follow-up period was 65 months (range, 3-81 months). Computed tomography was used to calculate the cephalic index (CI; equal to the maximum width of the head/maximum length of the head ×100), and the ratios of these indices at 3 different time periods (before, immediately after, and at 1 year postoperatively) were evaluated.


RESULTS
An average cranial compression of 18 mm was found to be possible with an average CI increase from 67.9 to 73.5. The CI ratio at 1 year after surgery was found to be the highest, showing a 9.8% increase.


CONCLUSIONS
Sagittal craniosynostosis patients are less easy to treat with conventional calvarial remodeling surgery if they are older than 1 year. Gradual cranial vault compression with distractors can be another option in these cases.
Department of Plastic Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea.
Tae Suk
TS
Oh
Young Shin
YS
Ra
Seok Ho
SH
Hong
Kyung S
KS
Koh
Yong Oock
YO
Kim
Jong-Woo
JW
Choi
D000367:Age Factors; D002675:Child, Preschool; D003398:Craniosynostoses / Q000000981:diagnostic imaging / Q000601:surgery*; D056424:Decompressive Craniectomy / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D008297:Male; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome