ABSTRACT
OBJECTIVE: The objective of the following study is to evaluate the results of strip craniectomy with distraction osteogenesis, using the intraoral distractor devices, as a modality of treatment for craniosynostosis. MATERIALS AND METHODS: Two cases of cranial synostosis were selected for this study. The cases were operated for strip craniectomy with distraction osteogenesis using a pair of miniaturized intraoral distractor devices. Distraction was carried out after a latency period of 4 days at a rate of 0.5 mm twice a day. Total separation of osteotomized segments achieved was in the range of 25-28 mm. RESULTS: Both patients were evaluated clinico-radiologically at 3, 6 and 12 months postoperatively. There was an increase in the occipital frontal circumference with improvement in the contour of the skull. Both the cases showed marked improvement of bowel habits, bladder control and cognitive behavior. Radiologically copper-beaten appearance reduced considerably suggesting improved intracranial pressure. CONCLUSION: Combination of distraction osteogenesis with strip craniectomy for the management of craniosynostosis is an effective treatment modality with promising results.
ABSTRACT
OBJECTIVE: To do a comparative study and evaluate the outcome in healing of reconstructed cranial defects with an autogenous bone graft vis-à-vis alloplastic materials. METHODS: A total of 22 patients with cranial defects were selected for this study. All the subjects were men; mean age was 27 years. Secondary reconstruction was done to obturate the defects. Of the 22 patients, 11 underwent cranioplasty with autogenous calvarial bone graft, 6 patients with a titanium mesh and 5 with a polymethylmethacrylate plate. RESULTS: The follow-up period ranged from 18 to 24 months. The 11 patients who were operated on with autogenous calvarial bone grafts did not develop any postoperative infection or complications. Graft uptake was complete, and the contour of the skull was improved in all the patients. Of the 5 patients operated on for secondary reconstruction with polymethylmethacrylate plates, 3 had exposure of the implant and 1 reported with secondary infection. Of the patients where secondary reconstruction was carried out with a titanium mesh only, 1 reported with secondary infection and 2 reported with thermal sensitivity. No graft resorption was detected. CONCLUSIONS: In our study, we concluded that autogenous calvarial bone grafts have better mechanical, biologic, and immunologic properties. This procedure allows the surgeon to reconstruct moderately large cranial defect with ease of access within single or adjacent incision to the operating site with minimal postoperative morbidity and discomfort.
