Novel Method for Treating Craniosynostosis: Description and Clinical Analysis

Introduction: Craniosynostosis is a condition in which one or more of the cranial sutures are closed prematurely resulting in an abnormal head shape and in some cases, disturb the orbit and facial structure or proper development of the brain. In most cases, the etiology for craniosynostosis is unknown. Occasionally, the disorder occurs as part of a syndrome (chromosomal disorder) which affects several systems. Most children with craniosynostosis do not develop additional symptoms apart from the cranial deformation. When a single suture is involved, the indication for treatment is purely esthetic. In cases exhibiting signs of increased intracranial pressure, the appropriate treatment consists of stripping of the sutures which prematurely closed. Treatment usually involves removing involved bones and positioning them in the proper shape using absorbing plates.

Objectives: Assess the clinical outcomes of treating craniosynostosis with the coiled osteotomy technique.

Methods: Retrospective study in which we collected the following data; date of birth, gender, age at the time of operation, other medical diagnoses, operative records of all surgical procedures performed, hospital course, complications, average volume of transfused blood, pre- and postoperative hemoglobin, dates of follow-up visits, findings at follow-up and the most recent assessment of outcome. Pre- and postoperative photographs were evaluated and scored by two independent examiners. To objectively compare our results, we use the classification of Whitaker as guidelines for satisfactory and unsatisfactory results.

Results: Between January 2017 and May 2019, 9 patients with craniosynostosis were treated: 5 with trigonocephaly, 3 with plagiocephaly and 1 with brachichephaly. The treatment consisted identical and standardized surgical technique of fronto-orbital advancement with the unique coiled osteotomy. The average age at surgery was 8.5 months. Not major complications were observed. When comparing our assessment using the Whitaker categories, we found a high correlation to the family`s assessment. No second interventions were required. High percent of our patients showed a complete correction/major improvement in the typical shaped deformity during their follow-up examination. בשיטות לרוב מכניסים נתונים מספריים יותר... אם יש

Conclusion: The use of the coiled osteotomy enables efficient reshaping of the skull and enables accommodation of the brain to the newly created cranial cavity. Additionally, aesthetic outcomes were acceptable and satisfying as judged by their families and the craniofacial team.