FOREHEAD REMODELING OF CRANIAL VAULT IN C RANIOSTENOSIS - PERSONAL TECHNIQUE APPLIED TO TRIGONOCEPHALY AND FRONTAL PLAGIOCEPHALY

The authors propose two simple techniques to improve the adaptation of the frontal vault after remodeling the orbito-naso-frontal flap in an terior craniostenosis. In trigonocephaly: the metopic suturectomy is e nlarged by lateral translation of the two half frontal bones, then to fall the place the coronal suture is used. The temporal plates are mov ed forward and turned to fill the failure of fronto-temporal junction due to valgisation of orbito-naso-frontal band. In plagiocephaly: the frontal flattened flap is cut with oblique radial osteotomies starting at bregma so called ''Daisy petal''. The first internal petal is sacr ified. The others are rotated axially in a medial direction. Internal table corticotomies must be performed at two levels to recurve the fla ttening and to obtain a curve in the coronal plane. In this two techni ques the pericranium and dura-mater must be carefully teated to obtain a better adaptation of the new bone shape and to permit the spontaneo us reossification.