A Craniometric Analysis of Posterior Cranial Vault Distraction Osteogenesis

• DOI: 10.1097/prs.0b013e31828bd541
• Publication Date: 2013-05-29T17:02:23Z
• Authors: Jesse A. Goldstein; J. Thomas Paliga; Jason D. Wink; David W. Low; Scott P. Bartlett; Jesse A. Taylor
• Keywords: Cranial vault; Vault (architecture)

Background: Posterior cranial vault distraction osteogenesis has replaced fronto-orbital advancement in some centers as the first-line treatment patients with syndromic craniosynostosis. Despite this fact, little been written about its craniometric effects on children Methods: A retrospective review of all who underwent posterior was performed. Patient demographic, perioperative data, and preoperative/postoperative computed tomographic scans were reviewed. Volumetric indices calculated measured using commercial three-dimensional imaging software. Results: From 2008 to 2012, 22 for suspected intracranial hypertension or severe turribrachicephaly. In 13 patients, first procedure performed, whereas eight had previous one parieto-occipital reshaping. Half before age 1 year; average at surgery 2.3 years (range, 0.3 14.1 years) length averaged 27.3 mm 19 35 mm). Average 2.9 hours 1.6 3.8 hours), blood loss 400 ml 200 600 ml). Total 91 days 48 147 days). Distraction Intracranial volume increase 21.5 percent 7.5 70.0 percent; p < 0.0001) 28.4 10.8 66.0 = 0.01) subset younger than year. height increased 12.2 0 0.002), basofrontal angle decrease 3.9 12 0.003), indicating a trajectory improvement frontal bossing. Conclusions: is safe effective operation that may lower risk abnormal skull morphology. Interestingly, morphological benefits seen both anteriorly posteriorly. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.