Evaluation of Staggered Osteotomy in Surgical Treatment of Trigonocephaly
Iranian Journal of Pediatric Surgery,
Vol. 3 No. 1 (2017),
3 October 2017
Introduction: undiagnosed metopic synostosis (Trigonocephaly) have many complications for infants such as Brain damage and cognitive & behavioral disorders, they also result in poor aesthetic features. There are many surgical techniques for this malformation which have their advantages and disadvantages; but with this new method (staggered osteotomy) we can solve some of these problems and minimize damages.
Materials and Methods: In this study, 20 infants with metopic synostosis underwent surgery in Mofid Children Hospital, Tehran. The minimum age of our patients was 4 months and the maximum was 9 months with an average of 6.72 months. Their diagnosis was confirmed with clinical symptoms & signs also with CTscan and paraclinical findings. Age and weight before and after surgery and anthropometric indices including: biparietal width and frontal width were recorded and reported.
Results: We found significant differences in anthropometric indices before & after surgery such as lowering of biparietal width after surgery and elevation of frontoparital index after surgery. Since in this procedure, we don’t separate the frontal bone segments and it keeps its frame, less plaques and screws are needed which will decrease the costs of surgery and the surgical time is much less than other techniques. Last but not the least, the satisfactions of parents were high and there was no need for secondary surgery.
Conclusion:Based on all the perfect results we got , it is safe to say that staggered osteotomy as a surgical method for correction of trigonocephaly is useful and we can use it as a new method in correction of metopic synostosis.
- Metopic synostosis
- Staggered osteotomy
How to Cite
Graham JM, deSaxe M, Smith DW: Sagittal craniostenosis: fetal head constraint as one possible cause. J Pediatr1979; 95: 747–750.
Wilkie AO: Molecular genetics of craniosynostosis in lin KY,ogle RC,Jane JA: Craniofacial surgery. Philadelphia,WB Saunders,2001:41-54.
Hoyte DA: The cranial base in normal and abnormal skull growth. NeurosurgClinNAm 1991; 2:515-37.
Hunter A.G.W, Rudd N.L: Craniosynostosis. I. Sagittal synostosis; its genetics and associated clinical findings in 214 patients who lacked involvement of the coronal suture(s). Teratology1976; 14:185–194.
Hunter AGW, Rudd NL: Craniosynostosis. II. Coronal synostosis: its familial characteristics and associated clinical findings in 109 patients lacking bilateral polysyndactyly or syndactyly. Teratology 1977; 15: 301–310.
Virchow R: Ueber den Cretinismus, namentlich in Franken, und über pathologische Schädelformen. Verh Physikalisch Med Ges Würzburg. 1851; 2: 230–271.
Fearon JA, Ko large JC, Munro IR: trigonocephaly-associated hypotelorism: is treatment necessary? PlastReconst Surg 1996; 97: 503-509.
Pashley DH, Broke JL: Biome chances and craniofacial morphogenesis, diagnosis, Evaluation and Management. NewYork , Oxford University Press 2000:84-100.
Frassanito P, Di Rocco C: Depicting cranial sutures: a travel into the history. Childs Nerv Syst. 2011; 27:1181-3.
Tessier P: Total facial osteotomy. Crouzon's syndrome, Apert's syndrome: oxycephaly, scaphocephaly, turricephaly. Ann ChirPlast. 1967;12:273-86.
Jane JA, Edgerton MT, Futrell JW, et al: Immediate correction of sagittal synostosis, 1978. J Neurosurg. 2007; 107:427-32.
Kelher MO, Murray DJ, McGilivary A, et al: Nonsyndromic trigonocephaly: surgical decision making and long-term cosmetic results. Childs Nervous System 2007; 23:1285-9.
Bonnier L, Ayadi K, Vasdev A, et al: Three-dimensional reconstruction in routine computerized tomography of the skull and spine. Experience based on 161 cases. J Neuroradiol 1991;18:250-66.
Darling CF, Byrd SE, Allen ED, et al: Three-dimensional computed tomography imaging in the evaluation of craniofacial abnormalities. J Natl Med Assoc 1994;86(9):676-80.
Kreiborg S, Marsh JL, Cohen MM Jr, et al: Comparative three-dimensional analysis of CT-scans of the calvaria and cranial base in Apert and Crouzon syndromes. J Craniomaxillofac Surg 1993;21(5):181-8.
Marsh JL, Vannier MW: The anatomy of the cranio-orbital deformities of craniosynostosis: insights from 3-D images of CT scans. ClinPlast Surg 1987;14(1):49-60.
Marsh JL, Vannier MW: Three-dimensional surface imaging from CT scans for the study of craniofacial dysmorphology. J Craniofac Genet Dev Biol 1989; 9(1):61-75.
Persing JA, Jane JA, Shaffrey M: Virchow and the pathogenesis of craniosynostosis: a translation of his original work. PlastReconstr Surg 1989;83(4):738-42
Frassanito P, Di Rocco C: Depicting cranial sutures: a travel into the history. Childs Nerv Syst 2011;27(8):1181-3
- Abstract Viewed: 452 times
- PDF Downloaded: 289 times