Coronal craniosynostosis treatment with spiral osteotomy for frontal cranial

Abstract

We present 12 cases of patients with coronal craniosynostosis treated with spiral osteotomy for frontal cranial remodeling, at the National Institute of Pediatrics, Mexico. Material and methods: a prospective, descriptive study was made, including patients from 3 to 34 months old with uni or bilateral coronal craniosynostosis, between August 2009 and January 2014. They were surgically treated with spiral osteotomy for remodeling the frontal bone. Pre and post-operative computed tomography and electroencephalograms were made. Variables studied were age, gender, coronal craniosynostosis type (left, right or bilateral), shape of remodeled frontal bone in computed tomography, electroencephalographic findings and surgical complications. Results: a total of 12 consecutive patients were treated with spiral osteotomy for remodeling the frontal bone. The frontal bone graft recontouring and advancement were successful in restoring the cranial vault morphology. Electroencephalographic findings were abnormal for most patients, with generalized slow wave activity generalized before and after surgery, without seizures. One patient suffer dural tear during craniotomy, and later hydrocephalus and bone resorption but it was not related with the spiral osteotomy. Discussion: we considered this surgical technique as a good option for remodeling the frontal bone in coronal craniosynostosis, without mayor morbility; and the electroencephalogram should be considered an indispensable study for the complete evaluation and following for these patients.