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Revista Brasileira de Cirurgia Plastica:
doi: 20130100.0-00006
Original Article

Nautilus-shaped dynamic craniotomy: a new surgical technique and preliminary results

Cardim, Vera Lucia Nocchi1; dos Santos Silva, Alessandra2; Salomons, Rolf Lucas2; do Valle Dornelles, Rodrigo Faria3; de Lima e Silva, Adriano2; de Souza Blom, José Orlofe4; Colange, Nelci Zanon5

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Abstract

Introduction:: Considering that craniosynostosis is a suture-related condition, the main challenge for its treatment is the fact that the brain is located in a closed compartment that does not have the required adaptability to accommodate its growth. The goal of treatment is to restore stenotic suture adaptability and correct the compensatory cranial deformity. This paper proposes the combined use of spiral osteotomy with distraction osteogenesis by the use of distracting springs to remodel craniofacial defects caused by craniosynostosis.

Methods:: Between July 2010 and July 2012, 10 patients with craniosynostosis were treated: 5 with oxycephaly, 3 with scaphocephaly, 1 with turricephaly, and 1 with trigonocephaly. The treatment consisted of the application of Lauritzen springs to correct the primary craniosynostosis defect in combination with a nautilus-shaped spiral craniotomy at the secondary deformation sites without dural detachment.

Results:: Resolution of cranial deformity and remission of the clinical signs of intracranial hypertension were observed. None of the patients had complications such as cerebrospinal fluid fistula, local infection, seroma, or hematoma.

Conclusions:: The combined use of spiral osteotomy with spring-mediated distraction or contraction enables active reshaping of the skull and facilitates accommodation of the brain by the cranial cavity. (clinicaltrials.gov identifier: NCT01672619)

© 2013 Sociedade Brasileira de Cirurgia Plastica

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