PR43P SPRING‐ASSISTED CRANIAL VAULT EXPANSION FOR THE TREATMENT OF BRACHYCEPHALY

Abstract

Purpose: To demonstrate the early postoperative outcomes of Spring‐assisted cranioplasty in brachycephaly. Spring‐Assisted Cranioplasty has become the first‐line treatment option for non‐syndromic sagittal synostosis in many centres. Although the use of springs has been documented in the management of bicoronal synostosis, the postoperative results have not been measured.Methodology: Between July 2008 and December 2008, three patients (2 Apert's, 1 Crouzon's) underwent Spring‐assisted cranial vault expansion. A retrospective review of patient's operative time and blood loss, hospital time, changes in cephalic index (CI) and intracranial volume, postoperative results (aesthetic results) and complications was undertaken.Results: Six springs were inserted in each case. The average age of the patients was 6 months, operative time averaged 76 minutes, operative blood loss was less than 50 ml, however two of three cases required blood transfusion day 1 postoperatively. Average hospital stay was four days, the preoperative CI was 91%, the 3‐month postoperative CI was 95.5%. The change in intracranial volume was 312 ml and 3‐month postoperative photographs are demonstrated.Conclusion: The Spring‐assisted cranioplasty offers an effective treatment of brachycephaly with reduced operative time and comorbidities. It requires less extensive operation compared to the conventional technique of cranial vault expansion. It is useful for brachycephalic patients with high risk of developing increased intracranial pressure.