USE OF PREOPERATIVE COMPUTED TOMOGRAPHY-ANGIOGRAPHY IN CRANIAL REMODELING - TECHNICAL NOTE

OBJECTIVE/IMPORTANCE: One of the most severe complications of craniosy nostosis repair is dural sinus laceration. Massive hemorrhage and air embolism are potentially life-threatening sequelae that can result fro m such an event. The aberrant anatomy of patients with craniosynostosi s only accentuates this risk, because separation of the calvaria from the underlying dura is often performed without direct visualization of the sinuses. METHODS: Three-dimensional computed tomography was combi ned with computed tomographic angiography in the preoperative assessme nt of patients with craniofacial abnormalities. RESULTS: A clear under standing of the dural sinus anatomy in relation to the overlying bony landmarks became available to the operating surgeon. Six patients unde rwent this procedure, with excellent visualization of the bony and sin us anatomy achieved in ail cases. CONCLUSION: It is thought, that the benefit of combining these procedures has been significant by allowing the visualization of the dural sinus anatomy and overlying bony landm arks. This procedure conveys minimal concomitant morbidity or expense to the patient, yet offers valuable insight toward operative planning and complication avoidance.