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Secondary Coronal Synostosis After Posterior Vault Distraction Osteogenesis
Marie Suzuki1, Yoshiaki Sakamoto1, Tomoru Miwa2
1Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo.
The Journal of Craniofacial Surgery
|November 17, 2025
Summary
Posterior vault distraction for nonsyndromic lambdoid synostosis surgery carries a high risk of secondary coronal synostosis. Careful monitoring and surgical planning are crucial for these patients.
Area of Science:
- Neurosurgery
- Pediatric Neurosurgery
- Craniofacial Surgery
Background:
- Secondary synostosis of cranial sutures after surgery is rare, especially in nonsyndromic cases.
- Risk factors for secondary synostosis in nonsyndromic patients undergoing lambdoid synostosis repair are not well-defined.
Purpose of the Study:
- To investigate the incidence and causes of secondary synostosis after surgical correction of lambdoid synostosis in nonsyndromic patients.
- To identify risk factors associated with secondary synostosis, focusing on posterior vault distraction.
Main Methods:
- Retrospective review of medical records for nonsyndromic patients treated for lambdoid synostosis (2015-2024).
- Exclusion of syndromic craniosynostosis cases.
- Assessment of postoperative cranial CT scans at 1 year for secondary synostosis.
- Statistical analysis including Mann-Whitney U, Fisher exact tests, and logistic regression.
Main Results:
- Posterior vault distraction was associated with a 100% incidence of secondary coronal synostosis (4/4 patients).
- Single-stage cranial remodeling did not result in secondary synostosis (0/9 patients).
- Bilateral lambdoid and sagittal synostosis (BLSS) correlated with secondary sagittal synostosis.
Conclusions:
- Posterior vault distraction is a significant risk factor for secondary coronal synostosis in nonsyndromic lambdoid synostosis.
- Judicious surgical planning and long-term monitoring are essential for patients undergoing these procedures.
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