Use of Multidirectional Cranial Distraction Osteogenesis for Cranial Expansion in Syndromic Craniosynostosis

Ataru Sunaga, MD; Yasushi Sugawara, MD; Hideaki Kamochi, MD, DDS; Akira Gomi, MD; Hirokazu Uda, MD; Shunji Sarukawa, MD; Kotaro Yoshimura, MD

doi:10.1097/GOX.0000000000001617

Plastic and Reconstructive Surgery, Global Open (Dec 2017)

Use of Multidirectional Cranial Distraction Osteogenesis for Cranial Expansion in Syndromic Craniosynostosis

Ataru Sunaga, MD,
Yasushi Sugawara, MD,
Hideaki Kamochi, MD, DDS,
Akira Gomi, MD,
Hirokazu Uda, MD,
Shunji Sarukawa, MD,
Kotaro Yoshimura, MD

Affiliations

Ataru Sunaga, MD: From the *Department of Pediatric Plastic Surgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan; †Department of Plastic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan; ‡Department of Plastic Surgery, Shizuoka Children’s Hospital, Urushiyama, Shizuoka, Japan; and §Department of Pediatric Neurosurgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan.
Yasushi Sugawara, MD: From the *Department of Pediatric Plastic Surgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan; †Department of Plastic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan; ‡Department of Plastic Surgery, Shizuoka Children’s Hospital, Urushiyama, Shizuoka, Japan; and §Department of Pediatric Neurosurgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan.
Hideaki Kamochi, MD, DDS: From the *Department of Pediatric Plastic Surgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan; †Department of Plastic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan; ‡Department of Plastic Surgery, Shizuoka Children’s Hospital, Urushiyama, Shizuoka, Japan; and §Department of Pediatric Neurosurgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan.
Akira Gomi, MD: From the *Department of Pediatric Plastic Surgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan; †Department of Plastic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan; ‡Department of Plastic Surgery, Shizuoka Children’s Hospital, Urushiyama, Shizuoka, Japan; and §Department of Pediatric Neurosurgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan.
Hirokazu Uda, MD: From the *Department of Pediatric Plastic Surgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan; †Department of Plastic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan; ‡Department of Plastic Surgery, Shizuoka Children’s Hospital, Urushiyama, Shizuoka, Japan; and §Department of Pediatric Neurosurgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan.
Shunji Sarukawa, MD: From the *Department of Pediatric Plastic Surgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan; †Department of Plastic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan; ‡Department of Plastic Surgery, Shizuoka Children’s Hospital, Urushiyama, Shizuoka, Japan; and §Department of Pediatric Neurosurgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan.
Kotaro Yoshimura, MD: From the *Department of Pediatric Plastic Surgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan; †Department of Plastic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan; ‡Department of Plastic Surgery, Shizuoka Children’s Hospital, Urushiyama, Shizuoka, Japan; and §Department of Pediatric Neurosurgery, Jichi Children’s Medical Center Tochigi, Shimotsuke, Tochigi, Japan.

DOI: https://doi.org/10.1097/GOX.0000000000001617
Journal volume & issue: Vol. 5, no. 12
p. e1617

Abstract

Read online

Summary:. Patients with syndromic craniosynostosis often require a large amount of cranial expansion to avoid intracranial hypertension, but the surgical procedure remains controversial. A patient of severe syndromic craniosynostosis with multiple bony defects and anomalous venous drainage at the occipital region was treated by multidirectional cranial distraction osteogenesis (MCDO) at the age of 8 months. Distraction started 5 days after surgery and ceased on postoperative day 16. The distraction devices were removed 27 days after completing distraction. After device removal, the increase of intracranial volume was 155 ml and the cephalic index was improved from 115.5 to 100.5. The resultant cranial shape was well maintained with minimal relapse at postoperative 9 months. In cases of syndromic craniosynostosis with multiple bony defects and/or anomalous venous drainage at the occipital region, expansion of the anterior cranium by MCDO is a viable alternative to conventional methods.

Published in Plastic and Reconstructive Surgery, Global Open

ISSN: 2169-7574 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://www.prsgo.com

About the journal