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Hybrid surgery for scaphocephaly with distraction osteogenesis using skull expanders: technical note
Nobuhito Morota1, Hideki Ogiwara, Tsuyoshi Kaneko
1Division of Neurosurgery, National Medical Center for Children and Mothers, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-Ku, Tokyo, Japan, 157-8535. morota-n@ncchd.go.jp
Summary
This surgical technique for scaphocephaly in older infants combines distraction osteogenesis with cranial reconstruction. It allows for significant skull expansion with minimal long-term regression and avoids postoperative helmets.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Presents a surgical technique for scaphocephaly in infants aged 5 months and older.
- Combines distraction osteogenesis using skull expanders with traditional cranial reconstruction.
Purpose of the Study:
- To describe a novel surgical approach for treating scaphocephaly in older infants.
- To evaluate the efficacy and outcomes of this hybrid surgical technique.
Main Methods:
- The procedure involves four main steps: strip craniotomy, occipital craniotomy, skull expander placement for distraction osteogenesis, and radial-oriented osteotomy.
- Skull expansion is initiated within a week, progressing at 5 mm/week up to 20-30 mm.
- Expanders are removed 4-6 months post-surgery after sufficient ossification is confirmed.
Main Results:
- Achieves maximum skull expansion with minimal long-term regression.
- Limited craniotomy results in reduced blood loss.
- Avoids skin complications associated with stretching and eliminates the need for postoperative helmets.
Conclusions:
- The described technique offers a viable option for scaphocephaly treatment in older infants.
- Advantages include maximized expansion, minimized regression, and reduced complications.
- A disadvantage is the temporary presence of a foreign body requiring a second surgery for removal.
