2019 Volume 35 Issue 2 Pages 46-52
During the past 30 years, over 100 cases of craniosynostosis and related syndromes have been treated by our unit. We have had more mild and subtle form cases not commonly diagnosed in the recent decade. We present six previously unclassified cases. The cranial form was mildly small with bi-coronal and pterional constriction in all cases, and fused coronal suture was confirmed intraoperatively. However, a concave line (constriction band) was posterior to (not on) the fused suture, and the increased intracranial pressure (ICP) was monitored. Osteotomy was performed on the abnormal constriction band and the concave line was removed. The lateral end of the sphenoid ridge was widely removed for release, and cranial expansion is performed by distraction or suturectomy. In three of these cases, bone re-generation was rapid in the bi-temporal area despite the wide bone defect, and further broader ostectomy was needed. Clinical symptoms, such as delay in speech and hyperactivity, were improved and single photon emission computed tomography (SPECT) image confirmed improved vasculature in the released temporal area after surgery.
