Scaphocephaly

Purpose. We describe a case of 3-year-old girl with rhombencephalosynapsis, a rare cerebellar anomaly. Patient. A 3-year-old girl was admitted to our hospital due to congenital torticollis and asymmetry of face, skull and trunk. Craniosynostosis was suspected due to abnormal head shape. 3D-CT revealed closure of the sagittal suture without scaphocephalic skull. Due to atypical craniosynostosis with neurological symptoms, brain-MRI was performed revealing rhombencephalosynapsis. Results. Our patient presented with atypical craniosynostosis and balance problems, not typical for scaphocephaly...

Craniosynostosis is classified according to the included sutures as either symmetric, such as scaphocephaly and brachycephaly, or asymmetric, such as plagiocephaly. Asymmetric craniosynostosis has been known to exert asymmetric effects not only on the cranium but also on the facial skeleton. Nonetheless, the presence of asymmetry in soft tissues is only speculative and is based on the experience of plastic surgeons. In our study, after measuring the surface coordinates of soft and bone tissues from numerous positions on three-dimensional computed tomography (CT), the distance between the coordinates was calculated and the thickness of the soft tissues was obtained by objective measurements...

BACKGROUND AND PURPOSE: Spring-assisted surgery has been used for the treatment of craniofacial deformities since its 1997 inception in Sweden by Dr Lauritzen (Scand J Plast Reconstr Surg Hand Surg 1998;32:331-338). Initial applications have focused on the treatment of patients with single-suture craniosynostosis. Recently, indications and applications have expanded to include patients with syndromic craniosynostosis, multiple-suture synostosis, and midface hypoplasia. The advancement of spring-assisted surgery in this country has been hindered by the need for patient-specific spring fabrication because few surgeons understand how to make the springs for each application...

AIM: Occurrence of secondary coronal synostosis (SCS) and its functional consequences were retrospectively analyzed in sagittal synostosis. PATIENTS AND METHODS: Occurrence of SCS and/or fingerprinting and clinical signs of raised intracranial pressure were investigated in children with scaphocephaly with a minimum follow-up of 3 years. Children were divided in 4 groups according to surgery (group 1: "H" craniectomy [193 patients]; group 2: craniectomies with removal of the coronal sutures [24 children]; group 3:"H" craniectomies and flap transpositions without total removal of the coronal suture [36 patients]; and group 4: 253 nonsurgical patients with scaphocephaly)...

UNLABELLED: Scaphocephaly is the most frequent craniosynostosis. Many correction techniques have been proposed. Their relevance is not completely appreciated by means of the Cranial Index, which cannot differentiate specifically the anterior and posterior modifications.The aim of this study was to propose a new fronto-occipital morphologic evaluation technique and its validation in normal and scaphocephalic patients, operated or nonoperated. PATIENTS AND METHODS: Two evaluation measures (indices) were developed for frontal and occipital deformities, traced over a standard skull radiograph...

INTRODUCTION: The association of a medulloblastoma and a syringomyelia has been already described in rare instances albeit without symptoms related to the syrinx. CASE REPORT: The case of a 23-year-old man operated in infancy for a medulloblastoma and then treated solely with adjuvant chemotherapy is reported. He was also operated in infancy for a scaphocephaly. With a very long time delay, he has developed a Chiari I and a symptomatic cervico-dorsal syringomyelia...

OBJECT: The prevalence of the different subtypes of craniosynostosis varies greatly. The aim of this study was to analyze the prevalences of the different subtypes of craniosynostosis at a single major craniofacial center and their changes during a 20-year period. METHODS: The medical charts of 2808 children hospitalized between 1988 and 2007 for a true craniosynostosis were retrospectively reviewed. Patients were divided according to their subtype of craniosynostosis (sagittal, plagiocephaly, brachycephaly, metopic, oxycephaly, syndromic cases, or unclassifiable)...

Metopic synostosis is thought to have an incidence of about 1 in 15,000 births. Traditionally, this makes it the third most frequent single-suture craniosynostosis, after scaphocephaly (1 in 4200-8500) and plagiocephaly (1 in 11,000). Our units have, independently from each other, noted a marked increase in the number of metopic synostosis over the recent years. This is a pan-European, retrospective epidemiological study on the number of cases with metopic synostosis born between January 1, 1997, and January 1, 2006...

Scaphocephaly is an important but incompletely defined entity resulting from premature fusion of the sagittal suture. Our goal was to use the clarity afforded by three-dimensional computed tomographies (CTs) to discern what characteristics of this disease are most representative and singular. Furthermore, we sought to define a classification system wherein the dominant physical trait, as it results from varied sites of premature fusion, determines the type of scaphocephaly in a particular patient. All patients with CT-diagnosed isolated single-suture sagittal craniosynostosis seen by a single craniofacial surgeon and a single pediatric neurosurgeon over a 5-year period are included (N = 76)...

BACKGROUND: Scaphocephaly is the most common type of craniosynostosis. In the medical literature, there is little information about the association of scaphocephaly and other congenital anomalies. PATIENTS AND METHODS: To determine the prevalence of genetic anomalies in scaphocephaly patients, a retrospective review of the medical charts of 30 consecutive patients was performed. A questionnaire was sent to parents to evaluate demographics. RESULTS: The male-female ratio was 2:1, 22% of patients were born at less than 37 weeks gestation, and 4% of the patients were twins...

AIM: The purpose of this study was to retrospectively evaluate the efficacy of the developed by the authors surgical technique in patients with a radiographically confirmed diagnosis of sagittal craniosynostosis. MATERIAL AND METHODS: 34 children with scaphocephaly underwent surgical treatment with the authors' operative technique. Quantitative assessments of the operative results, based on the preoperative and postoperative (1 year after the procedure) measurements of the cephalic index (cranial width / cranial length x 100), were performed in all patients...

Craniosynostosis is the premature fusion of 1 or more of the cranial sutures, with sagittal synostosis being the most common nonsyndromic single suture synostosis. The pathogenesis of craniosynostosis has been extensively studied and is likely multi-factorial. A complex interaction between the dura and overlying suture via multiple growth factors seems to play the most important role. There have been 3 published studies with patients presenting with scaphocephaly and a cephalohematoma, which raises the question of how the 2 conditions may be related...

BACKGROUND: Techniques for sagittal synostosis correction continue to evolve to improve outcomes and minimize morbidity. The techniques now used by our craniofacial service are spring-assisted cranioplasty for younger children (generally up to 9 months of age) and biparietal barrel staving with cross-struts using bioabsorbable plates for older children. We evaluate the evolution of, and rationale for, our current methods of treatment. METHOD: All patients who underwent surgery for craniosynostosis over the period 1982 to 2007 were retrospectively reviewed...

OBJECTIVE: To review the results and complications of the surgical treatment of craniosynostosis in 283 consecutive patients treated between 1999 and 2007. PATIENTS AND METHODS: Our series consisted of 330 procedures performed in 283 patients diagnosed with scaphocephaly (n=155), trigonocephaly (n=50), anterior plagiocephaly (n=28), occipital plagiocephaly (n=1), non-syndromic multi-suture synostosis (n=20), and with diverse craniofacial syndromes (n=32; 11 Crouzon, 11 Apert, 7 Pfeiffer, 2 Saethre-Chotzen, and 2 clover-leaf skull)...

A unique situation of twins with similar sagittal synostosis pathology who underwent different surgical corrective procedures allowed us an opportunity to compare an endoscopic technique to the more traditional technique of a modified cranial vault remodeling (CVR). At 4 months of age, 1 twin underwent an endoscopic-assisted extended strip craniectomy with postoperative helmet therapy for 12 months, and the other underwent a reverse pi CVR procedure. Cephalic index, the Whitaker Aesthetic score, and developmental tests were used for comparison during a 6-year follow-up...

BACKGROUND: The purpose of this project was to determine whether adult patients with frontal deformities caused by untreated craniosynostosis can undergo successful surgical correction. METHODS: Thirteen unoperated adult craniosynostosis patients are reported: seven women and six men, with a mean age of 24 years. There were four plagiocephalies, four scaphocephalies, three oxycephalies, and two brachycephalies. Computed tomographic scans with cerebral contrast were obtained, and the projected computerized correction was discussed with the patients...

BACKGROUND: Scaphocephaly is usually due to sagittal synostosis. Scaphocephaly may also be seen in the presence of a nonsynostosed sagittal suture. In this situation traditional surgery is controversial due to the altered risk-benefit profile. This paper reports the first known series of patients with nonsynostotic scaphocephaly treated using spring assisted expansion of the sagittal suture. METHODS: All patients referred to our craniofacial program over the period February 2005-February 2008 were retrospectively reviewed...

Correction of craniosynostosis represents much of the workload in the pediatric designated UK craniofacial units. We reviewed recent operations as part of an ongoing unit audit cycle with outcome determined as blood use and complications or readmissions within 6 weeks of surgery. A pro forma was designed, and information from a chart search was collated on a Microsoft Excel (Microsoft, Seattle, WA) spreadsheet. Thirty-four patients were treated between March 2005 and December 2006, including 13 who underwent scaphocephaly correction (SC) and 21 who underwent fronto-orbital advancement and remodeling (FOAR)...

OBJECTIVE: To review the complications in the surgical treatment of craniosynostosis in 306 consecutive transcranial procedures between June 1999 and June 2007. PATIENTS AND METHODS: Surgical series consist of 306 procedures done in 268 patients: 155 scaphocephalies, 50 trigonocephalies, 28 anterior plagiocephalies, one occipital plagiocephaly, 20 non-syndromic multisutural synostosis and 32 craniofacial syndromes (11 Crouzon, 12 Apert, seven Pfeiffer and two Saethre-Chotzen) Complications and time of hospitalisation were reckoned...

Ventricular shunt overdrainage may cause cranial vault collapse, deformation, and secondary craniosynostosis. There is a paucity of information in the literature about this condition or successful low morbidity methods to reshape the cranial vault. Spring-assisted cranioplasty was developed in the Göthenborg Craniofacial Unit and is part of our routine protocol for the treatment of selected patients with craniosynostosis. The same treatment principles were applied to skull deformity secondary to ventricular shunt-associated deformity...