Reverse Distraction for Treatment of Hydrocephalic Macrocephaly in Late Childhood
Autor: | Hannah Miller, Paul Grabb, Michael Lypka |
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Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Osteogenesis Distraction Ventriculoperitoneal Shunt 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine Holoprosencephaly Cranial vault medicine Humans Child 030223 otorhinolaryngology Craniotomy business.industry Skull Macrocephaly 030206 dentistry General Medicine medicine.disease Cranioplasty Megalencephaly Surgery Hydrocephalus medicine.anatomical_structure Otorhinolaryngology Distraction osteogenesis Female medicine.symptom Tomography X-Ray Computed business |
Zdroj: | Journal of Craniofacial Surgery. 30:532-534 |
ISSN: | 1049-2275 |
Popis: | Macrocephaly diminishes quality of life for children whose head size inhibits independent mobility and appropriate interaction with caregivers. Cranial reduction is a method of addressing these issues, historically with a high morbidity due most commonly to bleeding and shunt complications. The authors present a 9-year-old girl with holoprosencephaly and severe macrocephaly from progressive hydrocephalus who underwent cranial reduction via reverse distraction osteogenesis, a method to slowly reduce the skull volume. The patient underwent circumferential occipital temporoparietal frontal craniotomy with placement of 4 cranial distractors, followed approximately 1 month later by removal of the distractors and cranioplasty with resorbable fixation devices. The patient demonstrated significant postoperative improvement in head control and interaction in school activities. This is the oldest patient with macrocephaly treated with reverse distraction in the literature to date. The slow contraction of the cranial vault with limited bony surgery at the time of initial reduction provides an additional safety margin, and should be considered in older children presenting with profound macrocephaly. |
Databáze: | OpenAIRE |
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