Summary
The history of ideas on the pathogenesis and treatment of craniosynostosis syndromes is discussed, with special reference to the emerging role of cranio-facial units. Emphasis has changed from correction of established deformities, to early surgery to prevent such deformities, as well as relief of existing pathology such as exorbitism and raised intracranial pressure. These early operations, best performed in the first three months of life, essentially involve unilateral or bilateral fronto-orbital advancements. The coronal suture is released with a craniectomy, extended to the squamosal suture, and a wide temporal decompression performed. The frontal bone and superior orbital margin are mobilized and moved to their new position, and wired in place. Intermediate and late stage operations are also discussed, together with complications.
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Gillies H, Harrison SH (1950–51) Operative correction by osteotomy of recessed malar-maxillary compound in a case of oxycaphaly. Br J Plast Surg 3:123–127
Hoffman HF, Mohr G (1976) Lateral canthal advancement of the supraorbital margin; a new corrective technique in the treatment of coronal synostosis. J Neurosurg 45:376–381
McCarthy JG, Coccaro PJ, Epstein F, Converse JM (1978) Early skeletal release in the infant with cranio-facial dysostosis, the role of the spheno-zygomatic suture. Plast Reconstr Surg 62:334–346
Marchac D (1978) Radical forehead remodelling for cranio-stenosis. Plast Reconstr Surg 61:823–835
Moss ML (1959) The pathogenesis of premature cranial synostosis in man. Acta Anat (Basel) 37:341–370
Tessier P (1971) The scope and principles — dangers and limitations — the need for special training — in orbito-cranial surgery. Trans 5th Int Cong Plast Reconstr Surg, p 903
Whitaker LA, Shut L, Kerr LP (1977) Early surgery for isolated cranio-facial dysostosis, improvement and possible prevention of increasing deformity. Plast Reconstr Surg 60:575–581
Whitaker LA, Munro I, Salyer K, Jackson I, Ortiz-Monasterio F, Marchac D (1979) Combined report of problems and complications in 793 craniofacial operations. Plast Reconstr Surg 64:198
Virchow R (1851) Über den Cretinismus, namentlich in Franken, und über pathologische Schädelformen. Verhandl Phys Med Gesell Würzburg. 2:230–271
David DJ, Simpson DA, Poswillo D (in press) The craniosynostoses: Natural history, diagnosis and management. Springer, Berlin Heidelberg New York
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We acknowledge with pleasure the assistance of Dr. Julian White in preparation of this paper.
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David, D.J., Simpson, D.A. New perspectives in the treatment of craniosynostosis. Chir Plastica 6, 25–35 (1981). https://doi.org/10.1007/BF00264706
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DOI: https://doi.org/10.1007/BF00264706