Results of cranial vault reshaping

This study was designed to assess the outcome of cranial vault reshaping fo r correction of deformity of the skull and the upper face. A retrospective review of all children who underwent cranial vault reshaping by a single te am of surgeons between 1993 and 1996 was performed. There were 10 children in the series. The age at surgery ranged from 6 to 62 months (mean age, 25 months). Five children in the series had untreated sagittal craniosynostosi s with scaphocephaly, two had pansynostosis resulting in cloverleaf skull d eformity, and three had turricephaly after shunt treatment of hydrocephalus . There was no operative mortality. Blood loss ranged from 250 to 1,500 ml (mean, 422 ml). All patients needed transfusion. There were two major compl ications resulting from increased intracranial pressure, but both patients recovered completely with no neurological sequelae. Titanium plates and scr ews were used in all patients, but were removed in two when they became pal pable. The 5 children with sagittal craniosynostosis had a normal head shap e. The 2 children with cloverleaf skull have improved head shape with persi stent increased bitemporal width and round faces. The 3 children with turri cephaly after shunting have marked improvement with mild persistent deformi ty. This study shows that cranial vault reshaping is safe and can lead to a long-term normal head shape in children with late correction of sagittal c raniosynostosis. Children with more severe anomalies, particularly syndromi c patients, can be improved but will have persistent mild deformity.