Treatment of Brachycephaly: Traditional Cranioplasty vs. Distraction Osteogenesis

ABSTRACT

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.