IMR Press / JIN / Volume 21 / Issue 4 / DOI: 10.31083/j.jin2104106
Open Access Original Research
Craniofacial reconstructions in children with craniosynostosis
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1 Paediatric Neurosurgery Unit, Clinical Department of Neurosurgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
2 Clinical Department of Maxillofacial and Oral Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
*Correspondence: peter.spazzapan@kclj.si; spazzapanpeter@yahoo.it (Peter Spazzapan)
Academic Editors: Francesco Nicita and Rafael Franco
J. Integr. Neurosci. 2022, 21(4), 106; https://doi.org/10.31083/j.jin2104106
Submitted: 29 October 2021 | Revised: 24 December 2021 | Accepted: 18 January 2022 | Published: 1 June 2022
(This article belongs to the Special Issue Neuropediatrics, from basic science to clinical practice)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Craniosynostosis is a rare congenital disease of the skull. They arise when one or more cranial sutures ossify prematurely. This causes an obstruction to normal brain growth and leads to specific deformations of the skull, which may result in intracranial hypertension and cognitive delay. Materials and methods: We have retrospectively analysed all children treated at the Unit of paediatric neurosurgery of the University Medical Centre Ljubljana between June 2015 and September 2020. The following items have been recorded: affected suture, underlying syndromic condition, hydrocephalus, Chiari malformation, raised intracranial pressure, age at surgery, surgical technique, need for multiple operations and surgical complications. Results: During the study period, 71 children have been treated for craniosynostosis. The median postoperative follow-up was 31 months. There were: 54.9% sagittal, 25.3% metopic, 14.0% unicoronal, 1.4% bicoronal and 1.4% unilateral lambdoid craniosynostosis. Multiple sutures were affected in 2.8% cases. 7.0% of the cases were syndromic. Overall, 74 surgical procedures have been performed: frontoorbital advancement represented 40.5% of them; biparietal remodelling 32.4%: total cranial vault remodelling 22.9%; posterior distraction 2.7%; posterior expansion 1.3%. Median age at surgery was 12.8 months. Conclusions: The treatment of craniosynostosis is surgical and requires a multidisciplinary approach, with expertise in plastic and reconstructive surgery, maxillofacial surgery and neurosurgery. The aim of surgical treatment is to release the constrictive and deformative effect that the synostosis has on skull growth. This requires a remodelling of the neurocranium and, if necessary, of the viscerocranium. Beyond aesthetic purposes, the primary aim of surgical treatment is to permit a normal development of the brain.

Keywords
Craniosynostosis
Intracranial hypertension
Apneas
Hydrocephalus
Chiari malformation
Figures
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