Massimi Luca, Di Rocco Concezio
Pediatric Neurosurgery, Catholic University Medical School, Rome, Italy.
Childs Nerv Syst. 2012 Sep;28(9):1341-5. doi: 10.1007/s00381-012-1799-4. Epub 2012 Aug 8.
Several techniques are currently available for the surgical correction of sagittal craniosynostosis. The most recently introduced ones have been specifically designed to perform a mini-invasive approach in order to reduce the postoperative morbidity. Herein, the surgical steps of a personal, mini-invasive technique used to decrease the impact of the surgical scar are described.
The traditional biparietal skull expansion is realized through two to six short skin linear incisions (2-3 cm long) strategically scattered over the scalp, which allow the surgeon to perform a wide sagittal synostectomy, linear craniectomies along the coronal and lambdoid sutures, and barrel stave osteotomies on the frontal and occipital bones, if needed. No special instruments or postoperative molding therapy is required.
The main advantages of this technique are the poor visibility of the surgical scar, the reduction of the perioperative morbidity (blood transfusion, orbital edema, subcutaneous fluid collection), and the shortening of surgical times and postoperative hospitalization. The main limits are represented by the minor correction of the frontal bossing and the old age of children at surgery (no optimal results after 10-12 months of age).
