Problems of Cranial Height in Surgical Correction of Craniosynostosis

Abstract

It is well known that craniosynostoses, such as brachycephaly, trigonocephaly, oxycephaly, and cloverleaf skull, involve a high calvaria as part of the abnormal architecture of the cranium. The high calvaria can often cause difficulty with regard to frontoparieto-occipital harmony, when reshaping surgery is carried out for these types of craniosynostosis. With this in mind we have developed a simple procedure for surgical correction of the high calvaria in patients with craniosynostosis. The main steps of the operative procedure can be summarized as follows.

• 1. Forehead advancement is achieved in most cases.

• 2. Wide bitemporal coronal craniectomy is performed.

• 3. The parietal bone is removed, leaving the midline fragment on the sagittal sinus.

• 4. The midline fragment of the parietal bone is osteotomized at the posterior end. This allows the remaining parietal bone to float.