Open surgery in lambdoid-related plagiocephaly: detailed techniques, risks, and long-term results

Lambdoid craniosynostosis is the rarest form among monosutural ones, with a prevalence ranging between 1 and 4% of all craniosynostosis. Open-strip craniectomy used to be the common treatment method; however, a better understanding of the pathology as well as a more careful analysis of outcomes and complications led to a shift towards other techniques such as open cranial vault reconstruction, device-mediated distraction, and endoscopic procedures. The present paper will deal with open surgical options, namely open cranial vault reconstruction (OCVR) and device-assisted procedures (DAP). In particular in the paper the authors will describe the aforementioned techniques focusing on each surgical step (positioning and anesthesia, exposure, bony decompression, reconstruction vs device used, and closure). In addition, the paper will also describe risks and long-term results related to the surgical techniques in question.