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Endoscopic Spring-Mediated Distraction for Unilambdoid Craniosynostosis
Paul A Mittermiller1, Danielle H Rochlin1, Robert M Menard1,2
1Division of Plastic Surgery, Stanford University School of Medicine, Stanford.
The Journal of Craniofacial Surgery
|August 18, 2020
Summary
Endoscopic spring-mediated distraction effectively treats unilambdoid craniosynostosis in infants. This minimally invasive technique shows significant cranial vault remodeling with low complication rates and short hospital stays.
Area of Science:
- Pediatric Neurosurgery
- Craniofacial Surgery
- Minimally Invasive Surgery
Background:
- Craniosynostosis treatment has evolved, including spring-mediated distraction since 1998.
- Endoscopic and open approaches exist for single and multiple suture craniosynostosis.
- Endoscopic correction of lambdoid synostosis using springs is less documented.
Purpose of the Study:
- To describe and evaluate the senior author's endoscopic approach for spring-mediated distraction in unilambdoid craniosynostosis.
- To report on patient outcomes and the efficacy of this technique.
Main Methods:
- Retrospective analysis of endoscopic unilambdoid synostosis repairs.
- Endoscopic approach via a small incision, suturectomy, and placement of pre-bent springs.
- Monitoring of head shape improvement and radiographic measurement of distraction.
Main Results:
- Seven patients underwent the procedure with an average age of 9.4 months.
- Average spring expansion was 15.3 mm, with a median hospital stay of 2 days.
- No surgical complications were reported; cranial base angles improved by an average of 5.8°.
Conclusions:
- Endoscopic spring-mediated distraction is a safe and effective treatment for unilambdoid craniosynostosis.
- This approach offers significant vault remodeling with minimal patient morbidity.
- The technique is suitable for all patients with unilambdoid synostosis due to its efficacy and efficiency.
