scholarly journals Distraction osteogenesis with temporal bone remodeling for unicoronal craniosynostosis

2021 ◽  
Vol 4 (2) ◽  
pp. V15
Author(s):  
Phuong D. Nguyen ◽  
Ahmed Belal ◽  
George N. Washington ◽  
Matthew R. Greives ◽  
David I. Sandberg ◽  
...  
Keyword(s):  
Bone Remodeling ◽  
Temporal Bone ◽  
Distraction Osteogenesis ◽  
Gold Standard ◽  
Cranial Vault ◽  
Link Type ◽  
Younger Age ◽  
Cranial Vault Remodeling

Unicoronal craniosynostosis correction with fronto-orbital advancement and cranial vault remodeling has traditionally been the gold standard. Distraction osteogenesis has the advantage of increased size of movement without constriction of the scalp and decreased morbidity. Although fronto-orbital advancement and cranial vault remodeling are usually performed at 6 months of age or later, distraction osteogenesis is performed at a younger age, between 3 and 6 months, to take advantage of the infant bony physiology. Herein, the authors demonstrate a case of distraction osteogenesis for unicoronal craniosynostosis in a 3-month-old female with significant improvement of her orbital, nasal, and frontal symmetry. The video can be found here: https://vimeo.com/519047922

scholarly journals Rotation flap distraction osteogenesis for unicoronal synostosis

2021 ◽  
Vol 4 (2) ◽  
pp. V16
Author(s):  
Alvin Wong ◽  
Arvin R. Wali ◽  
Bryan Ryba ◽  
Mihir Gupta ◽  
Michael L. Levy ◽  
...  
Keyword(s):  
Distraction Osteogenesis ◽  
Cranial Vault ◽  
Intracranial Volume ◽  
Short Term ◽  
Traditional Methods ◽  
Case Examples ◽  
Rotation Flap ◽  
Cranial Vault Remodeling ◽  
Long Term Studies

Unicoronal craniosynostosis is notoriously difficult to treat, with long-term studies demonstrating high rates of relapse and the need for reoperation using open fronto-orbital advancement. Applying the principles of distraction osteogenesis to cranial vault remodeling has demonstrated promising short-term results that compare favorably with traditional methods, with simultaneous correction of both frontofacial and endocranial morphology, along with significant increases in intracranial volume. Here, the authors demonstrate their technique for rotation flap distraction osteogenesis in the treatment of unicoronal synostosis and provide case examples. The video can be found here: https://vimeo.com/519505008.

Lipo-Substitution of Masseter and Temporal Muscle with Intense Mandibular, Zygomatic, and Fronto-Temporal Bone Remodeling

2018 ◽  
Vol 126 (3) ◽  
pp. e43
Author(s):  
Luan Nathiel Santana Kovalski ◽  
Vinicius Coelho Carrard ◽  
Manoela Domingues Martins ◽  
Marcos Vinicius Martins Collares ◽  
Fabricio Bergelt De Sousa ◽  
...  
Keyword(s):  
Bone Remodeling ◽  
Temporal Bone ◽  
Temporal Muscle

scholarly journals Low intensity pulsed ultrasound accelerated bone remodeling during consolidation stage of distraction osteogenesis

2006 ◽  
Vol 24 (2) ◽  
pp. 263-270 ◽  
Author(s):  
Chun Wai Chan ◽  
Ling Qin ◽  
Kwong Man Lee ◽  
Ming Zhang ◽  
Jack Chun Yiu Cheng ◽  
...  
Keyword(s):  
Bone Remodeling ◽  
Distraction Osteogenesis ◽  
Pulsed Ultrasound ◽  
Low Intensity Pulsed Ultrasound ◽  
Low Intensity

Craniosynostosis following hemispherectomy in a 2.5-month-old boy with intractable epilepsy

2011 ◽  
Vol 8 (5) ◽  
pp. 450-454 ◽  
Author(s):  
Mohammad-Ali Jazayeri ◽  
John N. Jensen ◽  
Sean M. Lew
Keyword(s):  
Surgical Treatment ◽  
Brain Volume ◽  
Intractable Epilepsy ◽  
Infantile Spasms ◽  
Cranial Vault ◽  
Volume Loss ◽  
Brain Volume Loss ◽  
Course Of Action ◽  
Cranial Vault Remodeling

The authors report on the case of a 6-week-old boy who presented with infantile spasms. At 2.5 months of age, the patient underwent a right hemispherectomy. Approximately 3 months postoperatively, the patient presented with left coronal craniosynostosis. Subsequent cranial vault remodeling resulted in satisfactory cosmesis. Four years after surgery, the patient remains seizure free without the need for anticonvulsant medications. The authors believe this to be the first reported case of iatrogenic craniosynostosis due to hemispherectomy, and they describe 2 potential mechanisms for its development. This case suggests that, in the surgical treatment of infants with intractable epilepsy, minimization of brain volume loss through disconnection techniques should be considered, among other factors, when determining the best course of action.

scholarly journals Improved cephalic index following early cranial vault remodeling in patients with isolated nonsyndromic sagittal synostosis

2021 ◽  
Vol 50 (4) ◽  
pp. E7
Author(s):  
Arvid Frostell ◽  
Maryam Haghighi ◽  
Jiri Bartek ◽  
Ulrika Sandvik ◽  
Bengt Gustavsson ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Cranial Vault ◽  
Hospital Length Of Stay ◽  
Cephalic Index ◽  
Sagittal Synostosis ◽  
The Mean ◽  
Cranial Vault Remodeling

OBJECTIVE Isolated nonsyndromic sagittal synostosis (SS) is the most common form of craniosynostosis in children, accounting for approximately 60% of all craniosynostoses. The typical cranial measurement used to define and follow SS is the cephalic index (CI). Several surgical techniques have been suggested, but agreement on type and timing of surgery is lacking. This study aimed to evaluate the authors’ institutional experience of surgically treating SS using a modified subtotal cranial vault remodeling technique in a population-based cohort. Special attention was directed toward the effect of patient age at time of surgery on long-term CI outcome. METHODS A retrospective analysis was conducted on all patients with isolated nonsyndromic SS who were surgically treated from 2003 to 2011. Data from electronic medical records were gathered. Eighty-two patients with SS were identified, 77 fulfilled inclusion criteria, and 72 had sufficient follow-up data and were included. CI during follow-up after surgery was investigated with ANOVA and a linear mixed model. RESULTS In total, 72 patients were analyzed, consisting of 16 females (22%) and 56 males (78%). The mean ± SD age at surgery was 4.1 ± 3.1 months. Blood transfusions were received by 81% of patients (26% intraoperatively, 64% postoperatively, 9% both). The mean ± SD time in the pediatric ICU was 1.1 ± 0.25 days, and the mean ± SD total hospital length of stay was 4.6 ± 2.0 days. No patient required reoperation. The mean ± SD CI increased from 69 ± 3 to 87 ± 5 for patients who underwent surgery before 45 days of age. Surgery resulted in a larger increase in CI for patients who underwent surgery at a younger age compared with older patients (p < 0.05, Tukey’s HSD test). In the comparison of patients who underwent surgery before 45 days of age with patients who underwent surgery at 45–90, 90–180, and more than 180 days of age, the linear mixed model estimated a long-term loss of CI of 3.0, 5.5, and 7.4 points, respectively. CONCLUSIONS The modified subtotal cranial vault remodeling technique used in this study significantly improved CI in patients with SS. The best results were achieved when surgery was performed early in life.

Bone Grafts: An Overview of Bone Remodeling, Types and Recent Advances

2021 ◽  
pp. 6101-6105
Author(s):  
Gopala Krishna Ganta ◽  
Rama Krishna Alla ◽  
Kamala Cheruvu ◽  
Bharathi Ram Guduri
Keyword(s):  
Bone Graft ◽  
Bone Remodeling ◽  
Gold Standard ◽  
Bone Grafts ◽  
Form And Function ◽  
Recent Advances ◽  
And Function ◽  
Insight Into

Bone grafts are often used to retrieve the lost bone in the most acceptable, technical and skilful manner that enables to restore the form and function of the bone. Numerous bone graft materials have been developed to fill and/or remodel the bony defects. Though, autografts were considered to be the gold standard among the grafts available; they have got some inherent disadvantages. The current research is more focused on allografts, which addressed the problems associated with autografts. This article provides an insight into the remodeling process, and various types of bone grafts currently available. Also, the emphasis was given on the recent advances of the bone grafts.

Long-Term Neurocognitive Outcomes of Spring-Assisted Surgery versus Cranial Vault Remodeling for Sagittal Synostosis

2021 ◽  
Vol 147 (3) ◽  
pp. 661-671
Author(s):  
Michael Alperovich ◽  
Christopher M. Runyan ◽  
Kyle S. Gabrick ◽  
Robin T. Wu ◽  
Chelsea Morgan ◽  
...  
Keyword(s):  
Cranial Vault ◽  
Sagittal Synostosis ◽  
Neurocognitive Outcomes ◽  
Cranial Vault Remodeling

Nonsyndromic craniosynostosis in Vietnam: initial surgical outcomes of subspecialty mentorship

2021 ◽  
pp. 1-8
Author(s):  
Dang Do Thanh Can ◽  
Jacob R. Lepard ◽  
Nguyen Minh Anh ◽  
Pham Anh Tuan ◽  
Tran Diep Tuan ◽  
...  
Keyword(s):  
Scale Up ◽  
Unmet Need ◽  
Case Series ◽  
Surgical Care ◽  
Cranial Vault ◽  
Female Ratio ◽  
Estimated Blood Loss ◽  
Common Diagnosis ◽  
Cranial Vault Remodeling

OBJECTIVE There is a global deficit of pediatric neurosurgical care, and the epidemiology and overall surgical care for craniosynostosis is not well characterized at the global level. This study serves to highlight the details and early surgical results of a neurosurgical educational partnership and subsequent local scale-up in craniosynostosis correction. METHODS A prospective case series was performed with inclusion of all patients undergoing correction of craniosynostosis by extensive cranial vault remodeling at Children’s Hospital 2, Ho Chi Minh City, Vietnam, between January 1, 2015, and December 31, 2019. RESULTS A total of 76 patients were included in the study. The group was predominantly male, with a male-to-female ratio of 3.3:1. Sagittal synostosis was the most common diagnosis (50%, 38/76), followed by unilateral coronal (11.8%, 9/76), bicoronal (11.8%, 9/76), and metopic (7.9%, 6/76). The most common corrective technique was anterior cranial vault remodeling (30/76, 39.4%) followed by frontoorbital advancement (34.2%, 26/76). The overall mean operative time was 205.8 ± 38.6 minutes, and the estimated blood loss was 176 ± 89.4 mL. Eleven procedures were complicated by intraoperative durotomy (14.5%, 11/76) without any damage of dural venous sinuses or brain tissue. Postoperatively, 4 procedures were complicated by wound infection (5.3%, 4/76), all of which required operative wound debridement. There were no neurological complications or postoperative deaths. One patient required repeat reconstruction due to delayed intracranial hypertension. There was no loss to follow-up. All patients were followed at outpatient clinic, and the mean follow-up period was 32.3 ± 18.8 months postoperatively. CONCLUSIONS Surgical care for pediatric craniosynostosis can be taught and sustained in the setting of collegial educational partnerships with early capability for high surgical volume and safe outcomes. In the setting of the significant deficit in worldwide pediatric neurosurgical care, this study provides an example of the feasibility of such relationships in addressing this unmet need.

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