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Journal of Neurosurgical Sciences 1998 June;42(2):119-22

Copyright © 1998 EDIZIONI MINERVA MEDICA

lingua: Inglese

Occipital remoulding for correction of scaphocephaly in the young infant. Technical note

Maggi G., Aliberti F., Pittore L.

Division of Neurosurgery, “Santobono” Children’s Hospital, Naples, Italy


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Background. Several sur­gi­cal tech­niques ­have ­been ­described ­for cor­rec­tion of sca­phoc­e­pha­ly. Recent advanc­es in ­the ­field of cra­ni­o­fa­cial sur­gery ­have ­allowed ­more exten­sive oper­a­tive pro­ce­dures ­for ­the treat­ment of cra­ni­al ­vault anom­a­lies. In gen­er­al ­the ­aim of sur­gi­cal treat­ment is to pre­vent ear­ly refu­sion of ­the parie­tal ­bones ­after ­the sag­it­tal cra­niec­to­my asso­ciat­ed ­with ­the wid­en­ing of ­the bipa­rie­tal diam­e­ter. In chil­dren old­er ­than 6 ­months ­these pro­ce­dures ­may ­result unsat­is­fac­to­ry pro­vid­ing ­only a par­tial cor­rec­tion of ­the mal­for­ma­tion. Therefore oper­a­tive tech­niques of ­total cra­ni­al ­vault reshap­ing ­are report­ed in ­the lit­er­a­ture. Methods. We per­formed a sur­gi­cal pro­ce­dure of bipa­rie­tal wid­en­ing ­and occip­i­tal remould­ing in ­eight 3 ­month ­old ­infants ­with a ­marked def­or­ma­tion of ­the occip­i­tal prom­i­nence ­from sag­it­tal syn­os­to­sis.
Results. This tech­nique ­has pro­vid­ed excel­lent cos­met­ic ­results ­with an imme­di­ate cor­rec­tion of ­the parie­to-occip­i­tal mal­for­ma­tion. There ­have ­not ­been intra­op­er­a­tive com­pli­ca­tions ­and ­the post­op­er­a­tive ­course ­was unevent­ful.
Conclusions. The occipital remoulding is useful in young infants with a marked skull deformity; this technique will produce immediate restoration of an esthetically pleasing cranial shape and a more satisfactory cosmetic result compared to less extensive procedures.

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