European Journal of Plastic Surgery

, Volume 36, Issue 11, pp 679–684 | Cite as

Posterior cranial distraction in the treatment of craniosynostosis—effects on intracranial volume

  • Daniel SaiepourEmail author
  • Pelle Nilsson
  • Junnu Leikola
  • Per Enblad
  • Daniel Nowinski
Original Paper



Posterior cranial expansion has become increasingly practiced in the treatment of patients with craniosynostosis and a brachyturricephalic dysmorphology. This study aims to assess the gain in intracranial volume obtained by expanding the posterior cranial vault by internal distraction in these patients.


Three consecutive patients, one with Saethre–Chotzen syndrome, one with Apert syndrome, and one with nonsyndromic bicoronal synostosis underwent posterior cranial vault distraction using two pairs of distractors and a previously described accelerated distraction protocol. The procedure was performed at an average age of 5.3 (4.7–6.1) months. Intracranial volumes were calculated with OsiriX© from computer tomographies obtained prior to placement and removal of distractors.


The average gain in total intracranial volume was 21 (14–29) %. The volume of the anterior cranial fossa was increased by an average of 22.3 (4–41) %. However, the volume increase of the anterior cranial cavity had only a minor contribution to the total intracranial volume expansion.


Posterior cranial vault expansion with internal distractors has the potential to efficiently increase the volume of the intracranial cavity. From this small series, it appears that the volume gain is large, albeit variable, and that some remodeling may occur in the anterior cranium.

Level of evidence: Level V, therapeutic study


Craniosynostosis Intracranial volume Distraction Brachycephaly 


Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Daniel Saiepour
    • 1
    Email author
  • Pelle Nilsson
    • 2
  • Junnu Leikola
    • 3
  • Per Enblad
    • 2
  • Daniel Nowinski
    • 1
  1. 1.Craniofacial Center, Department of Surgical SciencesUppsala University HospitalUppsalaSweden
  2. 2.Craniofacial Center, Department of NeuroscienceUppsala University HospitalUppsalaSweden
  3. 3.Cleft Palate and Craniofacial Center, Department of Plastic SurgeryHelsinki University Central HospitalHelsinkiFinland

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