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CASE REPORT Pan-Suture Synostosis After Posterior Vault Distraction
Katrina F Chu1, Stephen R Sullivan, Helena O Taylor
1Warren Alpert Medical School of Brown University.
Insights
Posterior vault distraction for craniosynostosis may lead to a rare complication: pan-suture synostosis. This case highlights a potential risk following this surgical technique in children with bicoronal synostosis.
Area of Science:
- Craniofacial surgery
- Pediatric neurosurgery
- Genetics
Background:
- Posterior vault remodeling using distraction osteogenesis is an emerging technique for treating turribrachycephaly in children with bicoronal craniosynostosis.
- This procedure involves surgically expanding the posterior skull vault.
Purpose of the Study:
- To report a novel complication of posterior vault distraction: the development of pan-suture synostosis.
- To discuss the potential causes and implications of this complication.
Main Methods:
- A case report of an infant girl with bicoronal synostosis and Saethre-Chotzen syndrome.
- The patient underwent posterior vault distraction, achieving 34 millimeters of expansion with successful bone formation.
Main Results:
- One year after surgery, computed tomography revealed incidental, asymptomatic pan-suture synostosis.
- This represents the first documented instance of delayed craniosynostosis following posterior vault distraction.
Conclusions:
- Posterior vault distraction may be associated with the delayed development of pan-suture synostosis.
- Further research is needed to understand the pathogenesis and clinical significance of this complication.
Objective:
Posterior vault remodeling by distraction osteogenesis is a relatively new technique used for initial correction of turribrachycephaly in children with bicoronal craniosynostosis. We present a new potential complication from this procedure; a case of pan-suture synostosis subsequent to posterior vault distraction.
Methods:
We report an infant girl who presented with bicoronal synostosis in the setting of Saethre-Chotzen syndrome. She underwent posterior vault distraction and was distracted a total of 34 millimeters, with successful osteogenesis at the site.
Results:
One year postoperatively, the patient was found to have incidental, asymptomatic pan-suture synostosis on computed tomography.
Conclusions:
To our knowledge, this is the first reported case of delayed craniosynostosis after posterior vault distraction in the literature. The possible pathogenesis and significance of this case are discussed with a review of the current literature.
