Morphological improvement after multi-directional cranial distraction osteogenesis procedure for syndromic craniosynostosis.

Masahiro Kameda,Takaya Senoo,Isao Date,Eijiro Tokuyama

doi:10.3171/2021.1.focvid20116

Masahiro Kameda, Takaya Senoo + Show 2 more

Open Access

https://doi.org/10.3171/2021.1.focvid20116

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Journal: Neurosurgical focus: Video	Publication Date: Apr 1, 2021
Citations: 1	License type: CC BY 4.0

Affiliation: Okayama University

Abstract

The multidirectional cranial distraction osteogenesis (MCDO) procedure, which uses an external distraction device, enables tailor-made distraction in an arbitrary direction, eliminating the disadvantage of unidirectional distraction with an internal distraction device. Multiple-suture synostosis cases for syndromic craniosynostosis patients are better indicated for this procedure. Here the authors describe seven cases in which the MCDO procedure was used to treat syndromic craniosynostosis. In each case, the MCDO procedure and postoperative distraction, with reference to midsagittal vector analysis of normal morphology in Japanese children, resulted in morphological improvement.The video can be found here: https://vimeo.com/519006555

Highlights

The multidirectional cranial distraction osteogenesis (MCDO) procedure, which uses an external distraction device, enables tailor-made distraction in an arbitrary direction, eliminating the disadvantage of unidirectional distraction with an internal distraction device
We demonstrate MCDO procedure and postoperative distraction for a 3-year-old Apert syndrome boy who had a past history of tracheostomy for subglottic stenosis
Several bone pieces were connected with absorbable plates in the operation in order to distract these pieces in one lump

Summary

Introduction

The multidirectional cranial distraction osteogenesis (MCDO) procedure, which uses an external distraction device, enables tailor-made distraction in an arbitrary direction, eliminating the disadvantage of unidirectional distraction with an internal distraction device. We analyzed his skull shape with the reference of midsagittal vector analysis of normal morphology of the Japanese children. We performed preoperative model surgery using patient particular 3D skull actual size model. We placed bicoronal skin incision and performed subgaleal dissection of the scalp to expose skull. To design the actual osteotomy lines, the surgical guide was put on the skull.

Results

Conclusion