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Surgery Types

 
The first surgical treatment of craniosynostosis was undertaken by Lannelongue in 1892, and involved the correction of a sagittal synostosis. Since then, multiple procedures have been used for the treatment of this condition, ranging from simple suturectomies (removal of fused sutures without skull remodeling to extensive cranial vault reconstruction. The type of surgery done for craniosynostosis is unique to the surgeon performing the repair and unique to the suture is fused. I encourage parents to thoroughly research all their options before deciding which surgery is best for your child. Second and third opinions from different craniofacial surgeons are recommended if you are unsure of the first consult.

TYPES OF SURGERY FOR CRANIOSYNOSOSIS

Cranial Vault Reconstruction:-

Cranial Vault Reconstruction also known as CVR or traditional surgery is the most common surgery performed. It is a complex surgery and will require the use of both a paediatric neurosurgeon/Neurosurgeon and paediatric craniofacial surgeon.
Some surgeons prefer to do either just the front of the skull (anterior CVR) or just the back of the skull (posterior CVR). While other surgeons might choose an overall CVR depending on the degree of reconstruction needed. In some cases front orbit advancement (FOA) is performed to reconstruct the orbits around the eyes. FOA's are hardly ever performed without an accompanying CVR.
An incision is made in the scalp from ear to ear in either a zig-zag pattern or u-shape. The skull bones are then cut and removed by a paediatric neurosurgeon. A CVR should never be performed without the neurosurgeon whose job is to protect the durum that surrounds and protects the brain. A paediatric craniofacial surgeon then will reconstruct and piece the skull bones back together using plates, screws, and stitches. Most of these foreign objects are absorbable which means as the new bone grows the plates and screws will slowly disappear.

CVR Surgery Pro’s:

  • Immediate and often lasting correction of the deformity without any visible or palpable bony defects
  • Drastically reduced occurrences of secondary surgeries
  • More qualified surgeons available to perform CVR surgery
  • CVR is most successful when performed on children younger than one year of age but is highly successful when performed on even older children
  • Any complications with the durum or blood loss can be immediately handled.
  • Most successful treatment for multi-suture synostosis and severe cranial deformity.

CVR Surgery Con’s:

  • Blood loss with the need for blood transfusions
  • Highly invasive surgery that last 5 to 9 hours typically
  • Plates and screws most often are needed
  • 48 hour stay in ICU required , followed by 3 or 4 more days in hospital
  • Swelling and bruising

Strip Craniotomy:

Most commonly an incision is made across the scalp from ear to ear in a zig-zag or u-shaped pattern. However in some cases of Sagittal the incision has been made from the front of the scalp to the back across the middle. A strip of bone is usually removed where 2 sutures connect and cuts are usually made down the sides of the skull to allow for natural reshaping as the brain grows. Sometimes smaller pieces of bone are removed and the skull is then allowed to be remoulded as the brain grows and the open spots allow the natural growth to take place.

Barrell Stave Craniotomy:

This too is an open procedure so an incision is typically made from ear to ear. Strips and pieces of bone are removed and repositioned with some gaps and in places where reconstruction is needed the bones are cut into smaller, flowering shapes that will move and conform with the brain as it grows. Bone sometimes can be stitched back together without need of plates and screws.


 

 
 
Surgery stories
    

Cameron Rondi
Cameron Mark Rondi was born on the 10th of March at Olivedale Hospital. When he was born he was diagnosed with Craniosynosis, it was picked up at birth as he was born with facial distortion ...

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Blake Campbell
Blakes surgery day was 4 April 2006...

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Azia-lynn
(not so) little Azia-lynn is born 1 week early (on her original due date!) 8lb 15oz and 21 inches...

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Tiaan Heyns
Tiaan was diagnosed with Sagittal Synostosis at six weeks of age.

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Chris-Lee - Our Miracle Child
In January 2007 after several tests and treatment – I was told that I will not be able to have children. 

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Claire Badden

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For more information or support, please contact Robyn Rondi on - robyn.rondi@hotmail.com  or  082 601 8585