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Sagittal synostosis after excision of congenital pigmented nevus of the scalp: a possible complication of the tissue expansion technique

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Abstract

We report a case of sagittal synostosis that was detected because of cranial deformity 5 years after a congenital pigmented nevus of the scalp was resected using the tissue expansion (TE) technique. Currently, no case report describes the association between TE and craniosynostosis. To explain the mechanism of the craniosynostosis in the present case, we considered that the area of placement, number of expanders, injection schedule, age at operation, or a combination of these may have been responsible for early suture fusion. Considering that complete fusion of the sagittal suture was observed on the postoperative computed tomography but that the compensatory change of the cranial shape was relatively minor, we speculated that the changes in the patient’s skull could have been secondary (late-onset) sagittal synostosis caused by the surgery. Because the deformity in secondary craniosynostosis is relatively minor, it may be overlooked by some surgeons. We recommend careful placement of the expander and long-term follow-up, especially in infants.

Level of Evidence: Level V, risk/prognostic study.

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Conflict of interest

Takada Keiko and Tamada Ikkei declare that they have no conflict of interest.

Statement of Ethical Standards

This study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The formal approval of the ethical committee in our hospital is not required for retrospective observational studies.

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Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Children’s Medical Center, 2-8-29 Musashidai, Fuchu City, Tokyo, 183-8561, Japan

    Takada Keiko & Tamada Ikkei

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  1. Takada Keiko
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  2. Tamada Ikkei
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Correspondence to Tamada Ikkei.

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Keiko, T., Ikkei, T. Sagittal synostosis after excision of congenital pigmented nevus of the scalp: a possible complication of the tissue expansion technique. Eur J Plast Surg 38, 491–494 (2015). https://doi.org/10.1007/s00238-015-1099-9

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  • DOI: https://doi.org/10.1007/s00238-015-1099-9

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