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Dynamic Total Skull Remodeling by a Combination of Morcellation Craniotomy With Distraction Osteogenesis: The MoD Procedure

Nakajima, Hideo MD*; Sakamoto, Yoshiaki MD*; Tamada, Ikkei MD†; Ohara, Hirotoshi MD‡; Kishi, Kazuo MD*

Journal of Craniofacial Surgery:
doi: 10.1097/SCS.0b013e31821c0fef
Original Articles
Abstract

There are no procedures available to reconstruct the normal cranial shape irrespective of the type of cranial deformity with minimal patient stress and morbidity. To achieve dynamic total skull remodeling, we considered a new remodeling concept and developed a new procedure by combining morcellation craniotomy and distraction osteogenesis, termed the MoD procedure, and designed a distraction device, namely the angle variable distraction (AVD) system. Between 2000 and 2009, we treated 41 patients with craniosynostosis (28 and 13 cases of isolated and syndromic craniosynostosis, respectively) by using the MoD procedure with the AVD system. Compared with the conventional methods, the mean operative time was significantly shorter, and the mean transfusion volume was significantly less for the MoD procedure. In all the patients, good cranial shape and adequate cranial volume were achieved without serious complications. In conclusion, the MoD procedure with the AVD system is safe, effective, and reliable for dynamic total skull remodeling with minimal morbidity. It could be used to improve the previous surgical concepts for treating craniosynostosis.

Author Information

From the *Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, †Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Children's Medical Center, Tokyo; and ‡Department of Plastic and Reconstructive Surgery, National Hospital Organization Saitama National Hospital, Saitama, Japan.

Received October 19, 2010.

Accepted for publication November 19, 2010.

Address correspondence and reprint requests to Hideo Nakajima, MD, Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ward, Tokyo 160-8582, Japan; E-mail: nakajiprs@yahoo.co.jp; and Yoshiaki Sakamoto, MD, Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ward, Tokyo 160-8582, Japan; E-mail: ysakamoto@z8.keio.jp

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD