Cranioplasty For Craniosynostosis In The Negev: Our Experience And Surgical Concepts And Early Post Operative Results

Abstract

Introduction: Craniosynostosis is characterized by early fusion of cranial sutures resulting in a variety of structural phenotypes and neurological sequelae due to alteration in cranial volume and restriction of brain growth. Tessier introduced the modern concept of cranioplasty that included wide subperiosteal exposure of cranial vault and orbits complete separation and reposition of large parts of the skull including the orbits. The goal of this study is to describe our experience with surgical correction of craniosynostosis with its operative and early post-operative course and complications.Materials and methods: This is a retrospectives chart review of the first 62 consecutive children that underwent surgical cranioplasty for craniosynostosis at Soroka university medical center between Jan 1991 and Dec 2005. Results: Our surgical technique for each type of craniosynostosis is described as well as intra-operative and post-operative early complications. 57 out of 62 patients had isolated craniosynostosis. There was no gender difference with regarding to presence of synostosis or suture involvement. We had one case of intra-operative death. Six cases of significant complications including one CSF leak, one infection that required drainage, one case of transient leg ischemia and two cases of hematoma, 10 cases of minor complications and 46 cases with no complications. All patients required blood transfusion. Conclusion: cranioplasty for craniosynostosis is a safe procedure but it should be practiced in dedicated centers with advanced intra and post-operative monitoring and intensive care facilities with personnel experienced in these type of procedures.