Gestational echobiometry in brachycephalic bitches using high-definition ultrasonography / Ecobiometria gestacional em cadelas braquicefálicas utilizando ultrassonografia de alta-definição

The objective of the present study was to obtain echobiometric values for the most important canine maternal-fetal tissues using high-definition ultrasonography (HDUS) trying to update the formulas for predicting gestational age. Twelve healthy bitches of brachycephalic breeds weighing 7-13kg and aged one to four years were included. The fetuses were analyzed every day using conventional and high-definition ultrasonography from the eighth day after artificial insemination until the day of delivery, using the ACUSON S2000/SIEMENS ultrasound equipment and specific software. Embryonic and fetal structures; diameter of the embryonic vesicle; length of the embryo; biparietal diameter, abdominal length and kidney height; length of the femur, humerus, scapula, radius, and tibia; thickening of the stomach wall; adrenal length; and cardiac size were measured. These variables were correlated with gestational and adjusted tested according to regression models. The results obtained (P<0.001) for: lateral diameter of the gestational sac (R2=81.8%); length of the embryo (R2=85.7%); biparietal (R2=99.1%) and abdominal diameter (R2=97.2%); thickness of the gastric wall (R2=86.9%); length of the femur (R2=96.6%), radius (R2=97.5%), humerus (R2=96.5%), scapula (R2=95.8%) and tibia (R2=97.3%); kidney length (R2=95.8%) and height (R2=96.0%); adrenal length (R2=89.6%); heart length (R2=93.0%) and height (R2=91.5%) of the canine fetuses showed significant correlation with gestational days. This allowed monitoring fetal growth and estimation of age with high accuracy in different gestational periods.(AU)

O objetivo do presente estudo foi obter valores ecobiométricos para os tecidos materno-fetais caninos, usando a ultrassonografia de alta definição (HDUS), desenvolvendo fórmulas para prever a idade gestacional das cadelas. Doze cadelas saudáveis de raças braquicefálicas pesando 7-13kg e com idades entre um e quatro anos foram incluídas. Os fetos foram analisados diariamente com ultrassonografia convencional e de alta definição, do oitavo dia após a inseminação artificial até o dia do parto, utilizando o equipamento de ultrassom ACUSON S2000/SIEMENS e software específico. Estruturas embrionárias e fetais; diâmetro da vesícula embrionária; comprimento do embrião; diâmetro biparietal, comprimento abdominal e altura renal; comprimento do fêmur, úmero, escápula, rádio e tíbia; espessamento da parede do estômago; comprimento adrenal; e tamanho cardíaco foram medidos. Essas variáveis foram correlacionadas com o teste gestacional e ajustado de acordo com os modelos de regressão. Os resultados obtidos (P<0,001) para: diâmetro lateral do saco gestacional (R2=81,8%); comprimento do embrião (R2=85,7%); diâmetro biparietal (R2=99,1%) e abdominal (R2=97,2%); espessura da parede gástrica (R2=86,9%); comprimento do fêmur (R2=96,6%), rádio (R2=97,5%), úmero (R2=96,5%), escápula (R2=95,8%) e tíbia (R2=97,3%); comprimento do rim (R2=95,8%) e altura (R2=96,0%); comprimento adrenal (R2=89,6%); o comprimento do coração (R2=93,0%) e a altura (R2=91,5%) dos fetos caninos apresentaram correlação significativa com os dias gestacionais. Isso permitiu monitorar o crescimento fetal e estimar a idade com alta precisão em diferentes períodos gestacionais.(AU)

Gestational echobiometry in brachycephalic bitches using high-definition ultrasonography

ABSTRACT: The objective of the present study was to obtain echobiometric values for the most important canine maternal-fetal tissues using high-definition ultrasonography (HDUS) trying to update the formulas for predicting gestational age. Twelve healthy bitches of brachycephalic breeds weighing 7-13kg and aged one to four years were included. The fetuses were analyzed every day using conventional and high-definition ultrasonography from the eighth day after artificial insemination until the day of delivery, using the ACUSON S2000/SIEMENS ultrasound equipment and specific software. Embryonic and fetal structures; diameter of the embryonic vesicle; length of the embryo; biparietal diameter, abdominal length and kidney height; length of the femur, humerus, scapula, radius, and tibia; thickening of the stomach wall; adrenal length; and cardiac size were measured. These variables were correlated with gestational and adjusted tested according to regression models. The results obtained (P 0.001) for: lateral diameter of the gestational sac (R2=81.8%); length of the embryo (R2=85.7%); biparietal (R2=99.1%) and abdominal diameter (R2=97.2%); thickness of the gastric wall (R2=86.9%); length of the femur (R2=96.6%), radius (R2=97.5%), humerus (R2=96.5%), scapula (R2=95.8%) and tibia (R2=97.3%); kidney length (R2=95.8%) and height (R2=96.0%); adrenal length (R2=89.6%); heart length (R2=93.0%) and height (R2=91.5%) of the canine fetuses showed significant correlation with gestational days. This allowed monitoring fetal growth and estimation of age with high accuracy in different gestational periods.

RESUMO: O objetivo do presente estudo foi obter valores ecobiométricos para os tecidos materno-fetais caninos, usando a ultrassonografia de alta definição (HDUS), desenvolvendo fórmulas para prever a idade gestacional das cadelas. Doze cadelas saudáveis de raças braquicefálicas pesando 7-13kg e com idades entre um e quatro anos foram incluídas. Os fetos foram analisados diariamente com ultrassonografia convencional e de alta definição, do oitavo dia após a inseminação artificial até o dia do parto, utilizando o equipamento de ultrassom ACUSON S2000/SIEMENS e software específico. Estruturas embrionárias e fetais; diâmetro da vesícula embrionária; comprimento do embrião; diâmetro biparietal, comprimento abdominal e altura renal; comprimento do fêmur, úmero, escápula, rádio e tíbia; espessamento da parede do estômago; comprimento adrenal; e tamanho cardíaco foram medidos. Essas variáveis foram correlacionadas com o teste gestacional e ajustado de acordo com os modelos de regressão. Os resultados obtidos (P 0,001) para: diâmetro lateral do saco gestacional (R2=81,8%); comprimento do embrião (R2=85,7%); diâmetro biparietal (R2=99,1%) e abdominal (R2=97,2%); espessura da parede gástrica (R2=86,9%); comprimento do fêmur (R2=96,6%), rádio (R2=97,5%), úmero (R2=96,5%), escápula (R2=95,8%) e tíbia (R2=97,3%); comprimento do rim (R2=95,8%) e altura (R2=96,0%); comprimento adrenal (R2=89,6%); o comprimento do coração (R2=93,0%) e a altura (R2=91,5%) dos fetos caninos apresentaram correlação significativa com os dias gestacionais. Isso permitiu monitorar o crescimento fetal e estimar a idade com alta precisão em diferentes períodos gestacionais.

Craneosinostosis, una perspectiva pediátrica / Craniosynostosis, a pediatric perspective

La craneosinostosis se define como el cierre prematuro de una o más suturas del cráneo, que se manifiesta por una forma anormal de la cabeza. Es una condición infrecuente, pero requiere ser reconocida y derivada oportunamente a Neurocirugía para prevenir complicaciones. El objetivo de esta revisión es describir las características clínicas y genéticas más frecuentes de esta patología, su clasificación de acuerdo a la forma del cráneo y los signos más característicos para lograr reconocerla oportunamente. Se realizó una búsqueda de artículos científicos en bases de datos Pubmed, Scielo y EMBASE con las palabras craneosinostosis, plagio, escafo y braquicefalia. Se seleccionaron artículos en español e inglés que describieran las características de la patología y su manejo, optando por revisiones sistemáticas o recomendaciones de sociedades científicas cuando estuvieran disponibles. La craneosinostosis puede presentarse en forma aislada o asociada a otras deformidades. Su clasifi cación depende de la(s) sutura(s) afectada(s), lo que lleva a la forma característica del cráneo y de la presencia de otras malformaciones. Suele diagnosticarse y derivarse de forma tardía, lo que se asocia a complicaciones como hipertensión endocraneana y alteración del desarrollo encefálico. La cirugía precoz tiene menor comorbilidad y mejores resultados estético. En conclusión, la forma anormal del cráneo debe hacer sospechar la presencia de craneosinostosis, aunque se presente en forma aislada. El manejo quirúrgico antes del año de vida se asocia a mejor pronóstico.

Craniosynostosis is defined as the premature fusion of one or more skull sutures, characterized by an abnormal shape of the head. It is a rare condition but should be recognized and timely referred to Neurosurgery in order to prevent complications. The objective of this review is to describe the most frequent clinical and genetic characteristics of this pathology, its classification according to the shape of the skull, and the most characteristic signs to achieve timely recognition. A search for scientific articles in Pubmed, Scielo, and EMBASE databases was performed using the terms craniosynostosis, plagiocephaly, scaphocephaly, and brachycephaly. We selected articles in Spanish and English that described the characteristics of the pathology and about its management, choosing systematic reviews or recommendations from scientific societies when available. Craniosynostosis may occur in isola tion or associated with other deformities. Its classification depends on the affected suture(s), leading to the characteristic shape of the skull and the presence of other malformations. This condition is usually diagnosed and referred late, which is associated with complications such as intracranial hy pertension and impaired brain development. Early surgery has less comorbidity and better esthetic results. In conclusion, the abnormal shape of the skull must raise the suspicion of craniosynostosis, even if it occurs in isolation. Surgical management before one year of life is associated with a better prognosis.

Cranial measurement analysis of 3406 infants aged 0 to 6 months in Chongqing / 国际儿科学杂志

Objective The incidence and distribution of positional deformities ( PD) were studied by measuring cranial types of infants aged 0-6 months of 3 hospitals in Chongqing, and the recommended values of local PD were discussed. Methods Data of 3406 infants with 0-6 months head size measurements were col-lected from the Second Affiliated Hospital of Army Military Medical University, Yongchuan Maternal and Child Health Care Hospital and Wanzhou Maternal and Child Health Care Hospital from September 1, 2017 to August 31, 2018, cranial vault asymmetry ( CVA) and cranial index ( CI) were calculated. According to different age groups, observe the distribution of cranial types, and use the current international common diagnostic crite-ria to understand the incidence of cranial abnormalities, and analyze the distribution of percentile values of CVA and CI in infants in Chongqing. Results According to the current international standard diagnosis of PD, the incidence of simple brachycephaly was the highest ( 39. 9％) in the overall cranial abnormalities of infants, followed by brachycephaly with plagiocephaly was the second (36. 1％), simple plagiocephaly was the lowest (6. 9％), and normal cranial type only accounted for 17. 1％. The detection rates of plagiocephaly (36. 9％)and brachycephaly ( 67. 0％) were the lowest in the 0-2 months group, and the highest in the 3-4 months group (47. 3％/83. 3％), and then decreased in the 5-6 months group (46. 6％/80. 2％). Conclusion The basic values of cranial type measurement of full-term infants in chongqing were significantly different from inter-national reports, mainly due to the large CI value. The general international diagnosis standard for positional deformities do not conform to Chinese infants. We suggest that the reference value for positional deformities in this region is as follows: CVA≥0. 4 cm is abnormal, of which 0. 4 cm≤CVA<0. 6 cm for mild plagiocepha-ly, 0. 6 cm≤CVA<1. 0 cm for moderate plagiocephaly, CVA≥1. 0 cm for severe plagiocephaly; 82％≤CI≤91％ is abnormal, of which 91％≤CI <94％ for mild brachycephaly; 94％ ≤CI <99％ for moderate brachycephaly; CI≥99％ for severe brachycephaly. CI≤82％ is scaphocephaly.

Cranial measurement analysis of 3 406 infants aged 0 to 6 months in Chongqing / 国际儿科学杂志

Objective@#The incidence and distribution of positional deformities(PD)were studied by measuring cranial types of infants aged 0-6 months of 3 hospitals in Chongqing, and the recommended values of local PD were discussed.@*Methods@#Data of 3 406 infants with 0-6 months head size measurements were collected from the Second Affiliated Hospital of Army Military Medical University, Yongchuan Maternal and Child Health Care Hospital and Wanzhou Maternal and Child Health Care Hospital from September 1, 2017 to August 31, 2018, cranial vault asymmetry(CVA)and cranial index(CI)were calculated.According to different age groups, observe the distribution of cranial types, and use the current international common diagnostic criteria to understand the incidence of cranial abnormalities, and analyze the distribution of percentile values of CVA and CI in infants in Chongqing.@*Results@#According to the current international standard diagnosis of PD, the incidence of simple brachycephaly was the highest(39.9%)in the overall cranial abnormalities of infants, followed by brachycephaly with plagiocephaly was the second(36.1%), simple plagiocephaly was the lowest(6.9%), and normal cranial type only accounted for 17.1%.The detection rates of plagiocephaly(36.9%)and brachycephaly(67.0%)were the lowest in the 0-2 months group, and the highest in the 3-4 months group(47.3%/83.3%), and then decreased in the 5-6 months group(46.6%/80.2%).@*Conclusion@#The basic values of cranial type measurement of full-term infants in chongqing were significantly different from international reports, mainly due to the large CI value.The general international diagnosis standard for positional deformities do not conform to Chinese infants.We suggest that the reference value for positional deformities in this region is as follows: CVA≥0.4 cm is abnormal, of which 0.4 cm≤CVA<0.6 cm for mild plagiocephaly, 0.6 cm≤CVA<1.0 cm for moderate plagiocephaly, CVA≥1.0 cm for severe plagiocephaly; 82%≤CI≤91% is abnormal, of which 91%≤CI<94% for mild brachycephaly; 94% ≤CI<99% for moderate brachycephaly; CI≥ 99% for severe brachycephaly.CI≤82% is scaphocephaly.

Effect of Sleeping Positions Guidance on Deformational Plagiocephaly and/or Brachycephaly in Prematures / 中国康复理论与实践

Objective To investigate the effect of sleep position guidance on deformational plagiocephaly and/or brachycephaly (DPB) in the prematures. Methods 321 preterm infants in neonatal intensive care unit from October, 2012 to September, 2015 were divided into sleep positions guidance group (n=159) and control group (n=162). The sleep positions guidance group accepted sleeping positions guidance when they were in neonatal intensive care unit and followed up in child care clinic, and the control group accepted routine treatment and nursing. The incidences of DPB were compared. Results The incidences of mild (χ2=6.591, P=0.010), moderate (χ2=4.862, P=0.027) and se-vere (χ2=11.261, P=0.001) DPB were less in the sleep positions guidance group than in the control group. Conclusion Sleeping positions guidance may reduce the incidence of DPB in prematures.

Risk Factors for Plagiocephaly and Brachycephaly / 中国康复理论与实践

@#Objective To investigate the factors related with plagiocephaly and brachycephaly. Methods 239 infants with plagiocephaly and brachycephaly were investigated, and analyzed with univariate analyses and multivariate Logistic regression analysis. Results The factors, such as gestational age birth (OR=0.636, P<0.001), birth weight (OR=0.095, P<0.001), time of hospitalization (OR=1.307, P<0.001), preterm birth (OR=2.649, P<0.001), stay in newborn intensive care unit (OR=4.456, P<0.001), change the position (OR=0.046, P<0.001), accepted early intervention guidance (OR=0.054, P<0.001), were significantly related with plagiocephaly and brachycephaly. Conclusion Preterm birth, low birth weight, and newborn complications are the risk factors for plagiocephaly and brachycephaly, while change the position and early intervention may prevent it.

Risk Factors for Plagiocephaly and Brachycephaly / 中国康复理论与实践

Objective To investigate the factors related with plagiocephaly and brachycephaly. Methods 239 infants with plagiocephaly and brachycephaly were investigated, and analyzed with univariate analyses and multivariate Logistic regression analysis. Results The fac-tors, such as gestational age birth (OR=0.636, P<0.001), birth weight (OR=0.095, P<0.001), time of hospitalization (OR=1.307, P<0.001), preterm birth (OR=2.649, P<0.001), stay in newborn intensive care unit (OR=4.456, P<0.001), change the position (OR=0.046, P<0.001), accepted early intervention guidance (OR=0.054, P<0.001), were significantly related with plagiocephaly and brachycephaly. Conclusion Preterm birth, low birth weight, and newborn complications are the risk factors for plagiocephaly and brachycephaly, while change the posi-tion and early intervention may prevent it.

Two Children with Saethre-Chotzen Syndrome Confirmed by the TWIST1 Gene Analysis

Saethre-Chotzen syndrome is an autosomal dominant craniosynostosis syndrome, usually involving unior bilateral coronal synostosis and mild limb deformities, and is induced by loss-of-function mutations of the TWIST1 gene. Other clinical features of this syndrome include ptosis, low-set ears, hearing loss, hypertelorism, broad great toes, clinodactyly, and syndactyly. The authors of the present study report 2 children with clinical features of Saethre-Chotzen syndrome who showed mutations in the TWIST1 gene, and is the first molecular genetic confirmation of Saethre-Chotzen syndrome in Korea. The molecular genetic testing of the TWIST1 gene for patients with coronal synostoses is important to confirm the diagnosis and to provide adequate genetic counseling.

Frecuencia de hueso lambdoideo en cráneos con deformación artificial en el norte de Chile / Frecuency of wormian lambdoid bone in skulls with artificial deformation in Northern Chile

Los huesos suturales o wormianos son huesos accesorios, de importancia genética y hereditaria, considerados variables étnicas (Orts Llorca, 1958; Figún & Garino, 1992). Se caracterizan por ser diversos en número, tamaño y forma, ubicados en suturas y fontículos, de preferencia en suturas posteriores, predominando la frecuencia a nivel de sutura lambdoidea o parieto-occipital (Sappey 1888, Sicher, 1965; Sánchez-Lara et al., 2004). Son de interés para la anatomía humana, antropología física, imagenología y medicina legal (Lips & García-Hernández, 1983; Henríquez-Pino et al., 1992; Braga et al., 2000; García-Hernández et al., 2007). La deformación craneal, patológica o artificial, estimula la formación de centros accidentales de osificación, incrementando la presencia de osículos en suturas y fontículos (Del Papa & Pérez, 2007). La deformación craneal artificial era común en diversas culturas amerindias, con propósito estético, mágico, religioso, como forma de identificación étnica, social, nobleza o asociada al grupo gobernante (Torres-Rouff, 2007) y se realizaba aplicando tablas de madera o vendajes compresivos en la cabeza del recién nacido. La hipótesis de investigación es determinar si existe mayor número de osículos lambdoideos en cráneos de atacameños del norte de Chile con y sin deformación craneal artificial. Para cumplir este objetivo se estudiaron 77 cráneos atacameños de ambos sexos (27 deformados y 50 no deformados), seleccionados al azar entre 293 individuos exhumados del cementerio Coyo-Oriente, datados entre 300-1200 D.C. y que forman parte del Museo R.P. Gustavo Le Paige en San Pedro de Atacama de la Universidad Católica del Norte. Los cráneos fueron analizados, fotografiados y mensurados para determinar el índice craneano. Existe prevalencia de huesos lambdoideos en cráneos deformados (p<0,05=0,00000249247), con promedio de indice craneal con mayor hiperbraquicefalia (92,63 DS 9,72) y porcentaje de cráneos braquicefálicos con huesos...

Sutural or wormians bones are accesory bones, with genetic and heriditary importance, and consided ethnic variables (Orts Llorca, 1958; Figún & Garino, 1992). They are characterized by be variables in number, size and shape, located in sutures and fontanelles, preferably in posteriorly placed sutures (Sappey 1888, Sicher, 1965; Sánchez-Lara et al., 2007). They are of interest in human anatomy, physical anthropology, imagenology and legal medicine (Lips & García-Hernández, 1983; Henríquez-Pino et al., 1992; Braga et al., 2000; García-Hernández et al., 2007). Cranial deformation, pathological or artificial, stimulates the formation of accidental ossification centers, increasing the formation of ossicles in sutures and fontanelles (Del Papa & Pérez, 2007). Artificial cranial deformation was common in amerindian cultures, for aesthetic, magical or religious purpose, as a form of ethnic identificate, social, nobility or associated with the ruling group (Torres-Rouff, 2007) and it was performed applying wooden boards or bandages in the head of newborn. The hypothesis of investigation is to determinate if there is a greater number of ossicles lambdoid in skulls of atacameños in Northern Chile with and without artificial cranial deformation. To fulfill this goal we studied 77 atacameños skulls of both sexes (27 deformed y 50 not deformed), selected at random between 293 individuals of the Coyo-Orient cementery, dated between 300-1200 A.C. and these remains are part of the Museum R.P. Gustavo Le Paige in San Pedro de Atacama of the North Catholic University. All skulls were analyzed, photographed in all anatomical norms and measured to obtain the cranial index. There prevalence of lambdoid bones in artificial cranial deformed (p<0,05=0,00000249247), with average cranial index with greater hyperbrachycephaly (92,63 DS 9,72) and greater percentage of brachycephalic skulls with lambdoid bones (92,6 percent-32 percent; p<0,05=3,67073E-7).

Frecuencia del hueso interparietal o incaico en cráneos atácamenos (Lican antai) prehispánicos del norte de Chile / Frequency of interparietal bone or inca bone in pre-hispanic Atacamenos (Lican Antai) skulls of the north of Chile

El hueso interparietal se considera un hueso intercalar originado de centros independientes de osificación y rodeado por sus propias suturas. Se encontró en fósiles homínidos y humanos tempranos. Se cree que el occipucio sufre transformaciones por mutaciones al iniciarse la evolución humana reforzando esta teoría las variaciones suturales que presenta el occipital. Sería un rasgo genéticamente dominante, propuesta ratificada por estudios experimentales. Se observa con variadas formas según la fusión de los núcleos de osificación, por lo que todos los huesos ubicados en la zona de la escama del occipital no se pueden clasificar como suturales o wormianos y deben considerarse como parte del hueso interparietal. Tratando de confirmar la alta frecuencia obtenida en investigaciones anteriores realizadas en cráneos de individuos originarios del norte de Chile, se analizaron 83 cráneos de atacamenos prehispánicos de ambos sexos, seleccionados al azar entre 293 individuos exhumados del cementerio Coyo-Oriente, datados entre 300-1200 D.C período post-Tiwanaku y que forman parte del Museo R.P. Gustavo Le Paige en San Pedro de Atacama, dependiente del Instituto de Investigaciones Arqueológicas de la Universidad Católica del Norte, que fueron fotografiados en todas sus normas anatómicas y que se midieron paras obtener el índice craneal o cefálico. El hueso interparietal está presente en 23 de 83 cráneos, con una frecuencia de 27,71 por ciento, sin diferencias estadísticas significativas al 95 por ciento con investigaciones realizadas en cráneos de origen étnico similar y en otras etnias que presentan alta frecuencia de hueso interparietal. Por el contrario, se encontraron diferencias estadísticamente significativas al 95 por ciento con frecuencias determinadas en cráneos europeos caucásicos y euroasiáticos. Los autores integraron las tablas clasificatorias de Kadanoff y Hanihara-Ishida, para obtener una tabla modificada que permitiera clasificar ...

The interparietal bone is considered an intercalary bone originated by independent ossification centers and surrounded by its own sutures. It is found in early hominids and human fossils. It is believed that the occipital bone undergoes transformations by mutations at the beginning of human evolution. Reinforcing this theory are the suture variations that presents the occipital bone. It would be a dominant genetic characteristic, proposal ratified by experimental studies. It is observed with varied forms according to the fusion of the ossification nuclei; reason why all the bones located in the zone of the occipital flake cannot be classified as sutures or wormians and must be considered part of the interparietal bone. Trying to confirm the high frequency obtained in previous investigations realized in skulls of original individuals of the north of Chile, we analyzed 83 skulls of pre-Hispanic atácamenos (lican antai) of both sexes, selected at random between 293 individuals of the Coyo-Orient cementery, dated between 300-1200 A.C, post-Tiwanaku period and these remains are part of R.P Gustavo Le Paige's Museum in San Pedro de Atacama, which is part of the Institute of Archaeological Investigations of the North Catholic University. The remains were photographed in all anatomical norms and that were measured to obtain the cranial or cephalic Index. The interparietal bone is present in 23 of 83 skulls, with a frequency of 27.71 percent, without significant statistical differences to 95 percent with investigations realized in skulls of similar ethnic origin and other ethnic groups who present high frequency of interparietal bone. On the contrary, statistically significant differences to 95 percent were found with frequencies determined in caucasian and euroasiatics european skulls. The authors integrated the classificatory tables of Kadanoff and Hanihara-Ishida, to obtain a modified table that allowed to classify all the found variations ...

Treatment of Brachycephaly: Traditional Cranioplasty vs. Distraction Osteogenesis

Craniosynostosis refers to the premature fusion of single or multiple sutures of the cranial base or vault. It causes restriction of cranium and brain growth and variable morphologic deformity. Inadequate intracranial volume for rapid brain growth brings about increased intracranial pressure and functional impairment. To solve this problem, the key is the surgical decompression and insurance of adequate intracranial volume. Traditional surgical approach is frontal advancement with cranial vault remodeling, but has drawbacks such as invasiveness, long operation time, large amount of hemorrhage, difficult postoperative care, and frequent complications. Recently, distraction osteogenesis is used for the treatment of craniosynostosis. So, we compared cranial distraction osteogenesis with traditional cranioplasty about merits and drawbacks and present the effectiveness of cranial distraction osteogenesis. In a comparative study of cranioplasty and distraction osteogenesis, clinical documents and pre/ postoperative X-ray and CT scans of 12 brachycephaly patients were reviewed. From April, 1994 to October, 2001, 8 patients were treated with traditional cranioplasty and 4 patients were treated with distraction osteogenesis. We achieved not only an increase in intracranial volume but also merits such as a reduction in operation time and bleeding, easy postoperative care and low complication rate with distraction osteogenesis.