Surgical correction of scaphocephaly: experiences with a new procedure andfollow-up investigations

Introduction: Simple resection of the sagittal suture and the use of allopl astic material or extensive skull resections have long been proven to be un satisfactory in the treatment of sagittal synostosis, In contrast to these experiences, the immediate correction of skull shape seems to yield the bes t results without significant morbidity, Patients: Thirty-six scaphocephali c infants with an average age of 6.5 (3.5-14) months underwent operation by our craniofacial team since 1994, Methods: Wide resection of the sagittal suture was used in combination with a bone-strip resection along the corona l and lambdoid sutures, Occasionally partial resection and reshaping of the frontal or occipital bone was necessary to correct an extremely bulging sk ull. The cranial growth and shape was monitored by anthropometric skull mea surements in the last 20 patients, Results: Except in two cases, in which t he dura mater was minimally injured intraoperatively, no complications occu rred in any patient. Craniofacial oedema always occurred but disappeared af ter 72 h, The immediate correction of the skull shape was successful in all cases and was completed within 6 months postoperatively, There was no iatr ogenic bone defect one year after surgery. Postoperative skull shape and gr owth was normal. Conclusion: These procedures seem to be effective in the t reatment of scaphocephalus. Further normalization of skull shape is achieve d by unrestricted postoperative brain growth. (C) 2001 European Association for Cranio-Maxillofacial Surgery.