Treatment of Nonsyndromic Craniosynostosis Using Multi-Split Osteotomy and Rigid Fixation with Absorbable Plates

Nam, Su Bong; Nam, Kyeong Wook; Lee, Jae Woo; Song, Kyeong Ho; Bae, Yong Chan

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자료유형: 학술저널

저자정보: Nam, Su Bong (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) Nam, Kyeong Wook (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) Lee, Jae Woo (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) Song, Kyeong Ho (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) Bae, Yong Chan (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine)

저널정보: 대한두개안면성형외과학회 Archives of craniofacial surgery : ACFS Archives of craniofacial surgery : ACFS 제17권 제4호

발행연도: 2016.1

수록면: 211 - 217 (7page)

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Background: Nonsyndromic craniosynostosis is a relatively common craniofacial anomaly and various techniques were introduced to achieve its operative goals. Authors found that by using smaller bone fragments than that used in conventional cranioplasty, sufficiently rigid bone union and effective regeneration capacity could be achieved with better postoperative outcome, only if their stable fixation was ensured. Methods: Through bicoronal incisional approach, involved synostotic cranial bone together with its surrounding areas were removed. The resected bone flap was split into as many pieces as possible. The extent of this 'multi-split osteotomy' depends on the degree of dysmorphology, expectative volume increment after surgery and probable dead space caused by bony gap between bone segments. Rigid interosseous fixation was performed with variable types of absorbable plate and screw. In all cases, the pre-operational three-dimensional computed tomography (3D CT) was checked and brain CT was taken immediately after the surgery. Also about 12 months after the operation, 3D CT was checked again to see postoperative morphology improvement, bone union, regeneration and intracranial volume change. Results: The bony gaps seen in the immediate postoperative brain CT were all improved as seen in the 3D CT after 12 months from the surgery. No small bone fragment resorption was observed. Brain volume increase was found to be made gradually, leaving no case of remaining epidural dead space. Conclusion: We conclude that it is meaningful in presenting a new possibility to be applied to not only nonsyndromic craniosynostosis but also other reconstructive cranial vault surgeries.

#Craniosynostoses #Osteotomy #Absorbable implants

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