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Posterior remodeling flap for posterior plagiocephaly
Federico Di Rocco1, Alexandre Marchac, Caroline Duracher
1Craniofacial Unit, Department of Pediatric Neurosurgery, Necker Enfants Malades Hospital, 156 rue de Vaugirard, 75015, Paris, France. federico.dirocco@nck.aphp.fr
Insights
Posterior plagiocephaly is a common skull deformation in infants. This study details a surgical technique for posterior vault remodeling when conservative treatments fail, outlining its benefits and drawbacks.
Area of Science:
- Craniofacial Surgery
- Pediatric Neurosurgery
- Plastic Surgery
Background:
- Nonsynostotic posterior plagiocephaly is the most common infant skull deformity.
- The supine sleeping position, recommended to reduce sudden infant death, contributes to positional skull deformations.
- Conservative management includes physiotherapy and positional corrective measures.
Purpose of the Study:
- To describe the surgical technique for posterior vault remodeling in posterior plagiocephaly.
- To focus on the advantages and limitations of this surgical approach.
- To present the experience from a French National Referral Center for Faciocraniosynostosis.
Main Methods:
- Surgical correction is reserved for severe cases or late referrals unresponsive to conservative treatment.
- The technique involves creating a posterior bone flap.
- The bone flap is repositioned after contouring and rotation.
Main Results:
- (Study describes technique, results not detailed in abstract)
- (Study focuses on technique, outcomes not detailed in abstract)
- (Study focuses on technique, limitations not detailed in abstract)
Conclusions:
- Surgical posterior vault remodeling is an option for severe posterior plagiocephaly.
- The described technique offers a method for skull contour correction.
- Further evaluation of the technique's advantages and limitations is warranted.
Introduction:
Nonsynostotic posterior plagiocephaly has become the most common skull deformation since pediatricians have suggested the supine position for the newborns to reduce the risk of sudden death. Prevention of such a "positional" deformation or its management once it has occurred is mainly based on physical maneuvers such as physiotherapy and active positional corrective measures.
Selection Criteria:
Surgical correction, however, may be suggested in rare cases where deformation of the skull is so severe or the referral of the child is so late that physical corrective treatment cannot be taken into consideration. Surgical management is based on the creation of a posterior bone flap to be repositioned after the opportune contouring and rotation.
Purpose:
The aim of this paper is to describe the surgical technique used for posterior vault remodeling in posterior plagiocephaly at the craniofacial unit of Hopital Necker Enfants Malades (French National Referral Center for Faciocraniosynostosis) focusing on its advantages and limitations.
