Craniocerebral Disproportion Corrected With Biparietal Distraction Osteogenesis
Jordan R Whittles1,2, Timar Mascio3, James Baumgartner4
1From the Loma Linda University School of Medicine, Loma Linda, CA.
Insights
Ventriculoperitoneal shunts, vital for pediatric hydrocephalus, can cause craniocerebral disproportion. A novel biparietal distraction osteogenesis technique effectively treats scaphocephaly in shunted patients without shunt disruption.
Area of Science:
- Neurosurgery
- Pediatric Neurosurgery
- Craniofacial Surgery
Background:
- Ventriculoperitoneal shunt therapy is crucial for pediatric hydrocephalus.
- Shunting can lead to craniocerebral disproportion, including craniosynostosis and neurofunctional issues.
- Standard craniosynostosis repair is complicated by shunt placement.
Abstract:
Ventriculoperitoneal shunt therapy represents a lifesaving neurosurgical intervention in pediatric patients with hydrocephalus. Although necessary, research indicates that shunting may be associated with a spectrum of craniocerebral disproportion from frank craniosynostosis to later presenting neurofunctional symptoms and headaches. The surgical management of craniosynostosis is generally treated according to provider and institutional preference; however, shunt therapy presents difficulties for typical vault remodeling procedures. In this report, we describe the utility of a biparietal distraction osteogenesis configuration for the treatment of craniocerebral disproportion in 2 patients. A parallel arrangement of an anterior and a posterior set of 2 distractors allows for a doubling of the typical expansion of the parietal diameter. This method effectively alleviates the scaphocephaly without disruption of the shunt site. We propose our repair for the indication of sagittal craniosynostosis in the shunted patient.
