CORRECTION OF SCAPHOCEPHALY SECONDARY TO VENTRICULAR SHUNTING PROCEDURES

Craniosynostosis following ventricular shunting procedures for hydroce phalus has become a recognized complication of shunting procedures. Se condary synostosis results from a decrease in intracranial volume lead ing to collapse of the cranial vault. Since this represents a distinct etiopathogenesis different from that typically involved, the surgical approach should be altered. Eight patients with secondary scaphocepha ly underwent surgical reconstruction. The clinical data and radiograph ic studies were reviewed for these patients. The surgical approach con sisted of sagittal or parasagittal strip craniectomies, lateral osteot omies with bone-flap expansion, occipital and frontal remodeling as ne eded, and the application of rigid fixation to maintain contour and pr event recurrent collapse of the cranial vault. Patient follow-up range d from 3 to 37 months. Five of these patients were premature infants, an association not previously recognized in the literature. Satisfacto ry results were obtained in all patients. Keeping the craniectomy site s patent and achieving a more normal cranial contour through cranial r emodeling have provided good results in this population.