Transverse Distraction Osteogenesis for Posterior Narrowing of the Cranial Vault

Although conventional posterior vault distraction osteogenesis is known to achieve the greatest improvement in intracranial volume, anteroposterior expansion of the cranial vault is not always ideal in certain head shapes. Transverse posterior vault distraction osteogenesis is an alternative reconstructive strategy in patients presenting with recalcitrant multisuture craniosynostosis resulting in scaphocephaly with posterior narrowing. The authors present a multimedia demonstration of placing the cranial hinge points at the superior anterior aspect of the bone segments in order to achieve increased intracranial volume and significant improvement in posterior head shape, while preserving normal anterior skull dimensions.