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. 2022 Jan 5;44(1):2.
doi: 10.1186/s40902-021-00332-4.

The use of a single-piece bone flap for cranial reshaping in anterior craniosynostosis patients: clinical experience and a description of a novel technique

Hatan Mortada  1   2 , Ikhlas Altuawijri  3 , Taghreed Alhumsi  4
Affiliations

The use of a single-piece bone flap for cranial reshaping in anterior craniosynostosis patients: clinical experience and a description of a novel technique

Hatan Mortada et al. Maxillofac Plast Reconstr Surg. .

Abstract

Background: Craniosynostosis is known as premature closure of one or more of the cranial sutures. Anterior craniosynostosis involves anterior plagiocephaly and trigonocephaly. One of the issues in anterior craniosynostosis skull reshaping is maintaining an aesthetically pleasing forehead curve. Therefore, in this article, we demonstrate our novel technique to use a single-piece bone flap for cranial reshaping of the anterior mold in patients diagnosed with anterior craniosynostosis. A retrospective record review of patients who underwent single piece bone flap cranial reshaping for correction of unicoronal synostosis (UCS) and metopic synostosis (MS) at an Academic Institute in Riyadh, Saudi Arabia, between 2018 and 2020, was conducted.

Results: Six non-syndromic consecutive patients were included. Three of the patients had MS. The mean age at surgery was 11.16 months (range, 6-19 months). The average OR time was 315 min (range, 263-368 min). The average intraoperative blood loss was 225 ml (range, 100-400 ml). All patients had achieved acceptable functional and aesthetic results.

Conclusion: Our novel technique is an innovative and efficient reconstructive technique to simultaneously address MS and UCS and minimize intraoperative bleeding and surgery time. However, more studies with more cases are required.

Keywords: Bone flap; Cranial reshaping; Craniosynostosis; Plagiocephaly; Reconstruction; Trigonocephaly.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Case of trigonocephaly in a 13-month-old boy with metopic craniosynostosis showing conical shape forehead with ridge. A Preoperative images. B 9 months after surgery. C Forehead and supraorbital bar after remodeling on a side table. D Intraoperative images of marking done for cranium removal
Fig. 2
Fig. 2
Six-month-old baby girl, case of Trigonocephaly. A, B Preoperative 3D CT scan. C, D One-day postoperative. E Illustration of the single bone flap that was used in its original position in a trigonocephaly patient as the single bone flap after it was completely removed of anterior vault of the cranium as one piece till supraorbital rim and rotated 180°
Fig. 3
Fig. 3
Eight-month-old baby girl, case of plagiocephaly. A, B Preoperative 3D CT scan. C, D Day 1 postoperative. E The same illustration but in a plagiocephaly patient
See this image and copyright information in PMC

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