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Cranial remodelling

Ye Sel Kim, In Sung Park, Hyun Jung Kim, Dasom Kim, Nam Joon Lee, Im Joo Rhyu
OBJECTIVES: This study investigated whether there was any secular change in cranial vault morphology among Koreans born between the 1930s and 1970s, a period of dramatic shift in Korea's socioeconomic conditions. MATERIALS AND METHODS: Using three-dimensional MRI volumetry, we obtained the intracranial volume (ICV) and craniometric measurements of 115 healthy Koreans: 58 individuals (32 males and 26 females) born in the 1930s (1926-1936) and 57 (28 males and 29 females) born in the 1970s (1972-1979)...
March 15, 2018: American Journal of Physical Anthropology
Kerry A Morrison, James C Lee, Mark M Souweidane, Neil A Feldstein, Jeffrey A Ascherman
BACKGROUND: Surgical intervention during infancy for both syndromic and nonsyndromic patients with craniosynostosis remains the criterion standard of treatment with the 2 main options being open vault remodeling versus minimally invasive surgery. Although open cranial vault remodeling was initially considered a high-risk procedure, many advances have improved its safety. Despite this, there is a paucity of literature on the long-term outcomes of contemporary open craniosynostosis repair...
March 13, 2018: Annals of Plastic Surgery
Rajiv R Iyer, Carolyn M Carey, S Alex Rottgers, Lisa Tetreault, Nir Shimony, Jennifer Katzenstein, Ernesto Ruas, Gerald F Tuite
OBJECTIVE Infants with severe hydrocephalus and extreme macrocephaly typically undergo CSF diversion early in life, which can result in significant cranial deformity due to CSF overdrainage. In this scenario, overlap of the cranial plates can precede the development of secondary synostosis and/or severe, permanent cranial deformity. As a result, extensive cranial vault remodeling is sometimes undertaken later in life, which is often challenging and has been associated with mortality and a high morbidity rate...
March 2, 2018: Journal of Neurosurgery. Pediatrics
Christopher D Lopez, Anand Kumar, Alexander Y Lin, Christopher M Bonfield, Jeffrey Weinzweig, Thomas Naidich, Christopher M Smith, Peter J Taub
Removal of the fronto-orbital bandeau is one of the most critical components for procedures designed to correct anomalies of the craniofacial skeleton and remodel the anterior calvarial vault. It is also used to improve exposure of the anterior cranial fossa. It is arguably one of the more difficult portions of some craniofacial procedures. While the technique for fronto-orbito-sphenoid osteotomy has been frequently described, it has only been minimally detailed. Separation of bone in this region remains challenging due to the bone thickness, adjacent vital structures, and limited direct visibility...
February 27, 2018: Journal of Craniofacial Surgery
Michael G Brandel, Cecilia L Dalle Ore, Chris M Reid, Wendy W Zhang, William Zhu, Chinwe S Kpaduwa, Samuel Lance, Hal S Meltzer, Amanda A Gosman
INTRODUCTION: Methods of reporting quantitative results for distraction osteogenesis (DO) of craniosynostosis have been inconsistent. Therefore, the efficacy of differing techniques and timing in regard to volume change is not well established, with no uniform metric for comparisons. Given that cranial vault remodeling with DO may be completed with different approaches, analysis was made to determine (1) the relative efficiency of different approaches in expanding intracranial volume (ICV) and (2) the impact of adjusting for ICV growth on measured DO efficiency...
February 27, 2018: Annals of Plastic Surgery
Peter Abraham, Michael G Brandel, Cecilia L Dalle Ore, Chris M Reid, Chinwe S Kpaduwa, Samuel Lance, Hal S Meltzer, Amanda A Gosman
INTRODUCTION: Timing of intervention and complication profiles in surgical repair of craniosynostosis have been widely debated. Early intervention is frequently promoted as a means of decreasing morbidity while maintaining favorable outcomes via minimally invasive techniques such as endoscopic strip craniectomy. Immediate postoperative morbidity due to complications of early vs late intervention remains a key element in comparing timing and technique for craniosynostosis repair. In addition, concurrent fronto-orbital advancement with open cranial vault remodeling may increase the risk of postoperative complications...
February 27, 2018: Annals of Plastic Surgery
Ljubisa Borota, Ehab Mahmoud, Christoffer Nyberg, Anders Lewén, Per Enblad, Elisabeth Ronne-Engström
The aim of this study was to describe our experience in the treatment of various pathological conditions of the cranial and spinal blood vessels and hypervascularized lesions using dual lumen balloon catheters. Twenty-five patients were treated with endovascular techniques: two with vasospasm of cerebral blood vessels caused by subarachnoid hemorrhage, one with a hypervascularized metastasis in the vertebral body, two with spinal dural fistula, four with cerebral dural fistula, three with cerebral arteriovenous malformations, and 13 with aneurysms...
February 23, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Alexandra Macmillan, Joseph Lopez, Gerhard S Mundinger, Melanie Major, Miguel A Medina, Amir H Dorafshar
BACKGROUND: Late treatment of scaphocephaly presents challenges including need for more complex surgery to achieve desired head shape. Virtual surgical planning for total vault reconstruction may mitigate some of these challenges, but has not been studied in this unique and complex clinical setting. METHODS: A retrospective chart review was conducted for patients with scaphocephaly who presented to our institution between 2000 and 2014. Patients presenting aged 12 months or older who underwent virtual surgical planning-assisted cranial vault reconstruction were included...
February 23, 2018: Journal of Craniofacial Surgery
Elena Pellicer, Babette S Siebold, Craig B Birgfeld, Emily R Gallagher
BACKGROUND: The recommended treatment for craniosynostosis, is cranial vault expansion to prevent increased intracranial pressure and optimize developmental outcomes. Some patients complain about postoperative headaches and occasionally require revision to treat increased intracranial pressure. This study examines whether specific factors are associated with an increased risk of postoperative headaches or intracranial hypertension. METHODS: This retrospective cohort included patients with craniosynostosis from 1995 and 2010...
March 2018: Plastic and Reconstructive Surgery
Bojana Zivkovic, Mirko Micovic, Vladimir Bascarevic, Andrija Savic, Lukas Rasulic
The most common location for intracranial arachnoid cysts is the region of the Sylvian fissure, where they can be found in 49% of cases. Management of these cysts is still quite controversial. We present our surgical technique for the treatment of large Sylvian fissure arachnoid cysts which involves cyst decompression and simultaneous calvarial remodeling. After decreasing cyst size, remodeling of the frontal, temporal, and parietal bones follows. The cyst itself is treated with a cystoperitoneal shunt. In immediate postoperative period, correction of the deformity is observed...
February 21, 2018: Neurosurgical Review
Tara L Braun, Bradley S Eisemann, Olushola Olorunnipa, Edward P Buchanan, Laura A Monson
BACKGROUND: Premature fusion of the metopic suture leads to a range of clinical presentations, with more severe patients presenting characteristically with trigonocephaly. Endoscopic-assisted correction of craniosynostosis is emerging as an alternative to the gold-standard open cranial vault remodeling. While there are several documented benefits of endoscopic correction, the management of craniosynostosis varies widely in the literature with little consensus as to the preferred timing and surgical technique for repair...
February 14, 2018: Journal of Craniofacial Surgery
Khai Luen Koh, Ali Zain
: Open cranial vault remodeling techniques require rigid fixation with hardware such as plates and screws; however, complications can occur. The purpose of this study was to assess the surgical outcome after open reconstruction for craniosynostosis with less rigid fixation using nonabsorbable suture. METHODS: Retrospective review of patients who underwent open craniofacial reconstruction for craniosynostosis at the Hospital Kuala Lumpur between January 2011 and December 2016 were performed...
February 12, 2018: Journal of Craniofacial Surgery
Amandeep Kumar, Gaurav Varshney, Pankaj K Singh, Deepak Agrawal, Guru D Satyarthee, Poodipedi S Chandra, Shashank S Kale, Ashok K Mahapatra
BACKGROUND: Atlantoaxial spondyloptosis (AAS), which is defined as complete displacement of facets of atlas anterior to the facets of axis such that there is no contact between the 2 articulating surfaces, is an extremely rare manifestation of atlantoaxial instability. The reason for an extreme rarity of traumatic AAS is probably the severity of injury in traumatic AAS that is usually incompatible to life. It represents the most severe form of atlantoaxial dislocation, and complete reduction in such a case presents a real technical challenge because of the interlocking of C1-C2 facets...
February 2018: World Neurosurgery
Ryan Winters, Sherard A Tatum
We describe a novel measurement of cranial morphology in pre- and post-operative scaphocephalic patients to complement the cephalic index. This will better describe restoration of normal skull and head shape, further defining the nuances of the corrected skull. In this retrospective comparative study the location of the euryon on the skull was statistically significantly different in preoperative scaphocephalic patients versus non-scaphocephalic controls. This difference was resolved with surgical cranial vault remodeling, indicating restoration of a normal skull profile...
December 29, 2017: Journal of Cranio-maxillo-facial Surgery
Andrea Torroni, Chongchen Xiang, Lukasz Witek, Eduardo D Rodriguez, Roberto L Flores, Nikhil Gupta, Paulo G Coelho
WE43 Mg alloy, composed of Mg, Yttrium, Rare Earth elements, and Zirconium, has proved to be a suitable candidate for production of resorbable osteosynthesis implants in both clinical and experimental settings. In a previous study we tested biocompatibility and degradation properties of untreated (as-cast) and artificially aged (T-5) WE43 Mg-alloys as subperiosteal implants on a maxillofacial sheep model. Both the alloy compositions showed excellent biocompatibility, however, with respect to degradation rate, the as-cast form showed increased degradability compared with the T-5...
January 4, 2018: Journal of Cranio-maxillo-facial Surgery
John W Verano
Trepanation is the scraping, cutting, or drilling of an opening (or openings) into the neurocranium. World surveys reveal that a number of ancient cultures experimented with cranial surgery, and that in some areas these practices continued into modern times. Archaeological discoveries of possible trepanations continue to be made, often from geographic areas or time periods from which the practice was not previously known. Unfortunately, most of these reports describe single crania with healed defects interpreted as trepanations...
December 2017: International Journal of Paleopathology
Erik M Wolfswinkel, Lori K Howell, Artur Fahradyan, Beina Azadgoli, J Gordon McComb, Mark M Urata
BACKGROUND: Of U.S. craniofacial and neurosurgeons, 94 percent routinely admit patients to the intensive care unit following cranial vault remodeling for correction of sagittal synostosis. This study aims to examine the outcomes and cost of direct ward admission following primary cranial vault remodeling for sagittal synostosis. METHODS: An institutional review board-approved retrospective review was undertaken of the records of all patients who underwent primary cranial vault remodeling for isolated sagittal craniosynostosis from 2009 to 2015 at a single pediatric hospital...
December 2017: Plastic and Reconstructive Surgery
Alexandre Anesi, Marzia Ferretti, Francesco Cavani, Roberta Salvatori, Michele Bianchi, Alessandro Russo, Luigi Chiarini, Carla Palumbo
Clinical advantages of piezosurgery have been already proved. However, few investigations have focused on the dynamics of bone healing. The aim of this study was to evaluate, in adult rabbits, bone regeneration after cranial linear osteotomies with two piezoelectrical devices (Piezosurgery(®) Medical - PM and Piezosurgery(®) Plus - PP), comparing them with conventional rotary osteotomes (RO). PP was characterized by an output power three times higher than PM. Fifteen days after surgery, histomorphometric analyses showed that the osteotomy gap produced with PM and PP was about half the size of that produced by RO, and in a more advanced stage of recovery...
October 12, 2017: Journal of Cranio-maxillo-facial Surgery
Michael S Golinko, Danielle N Atwood, Eylem Ocal
PURPOSE: Cerebrospinal fluid diversion via ventricular shunt is a common treatment for hydrocephalus. Change in cranial morphology associated with a sutural fusion has been termed shunt-related or induced craniosynostosis (SRC) or craniocerebral disproportion (CCD). We present a series of patients with SRC who underwent cranial vault remodeling (CVR) and our treatment algorithm. METHODS: Thirteen patients were retrospectively reviewed who had SRC and CVR; 92% of patients had a ventriculoperitoneal (VP) shunt placed for largely intraventricular hemorrhage of prematurity (69% of patients) at a mean age of 2...
November 6, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Jonathan M Bekisz, Elise Fryml, Roberto L Flores
This study presents a systematic review of randomized controlled trials (RCTs) in cleft and craniofacial surgery. All studies reporting on RCTs in cleft and craniofacial surgery were identified on PubMed using the search terms "cleft," "velopharyngeal insufficiency," "velopharyngeal dysfunction," "nasoalveolar molding," "gingivoperiosteoplasty," "Pierre Robin sequence," "craniofacial," "craniosynostosis," "craniofacial microsomia," "hemifacial microsomia," "hypertelorism," "Le Fort," "monobloc," "distraction osteogenesis," "Treacher Collins," and "Goldenhar...
October 27, 2017: Journal of Craniofacial Surgery
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