Craniofacial Distraction in the Management of Anterior Plagiocephaly: A Novel Idea and a Systematic Review of the Literature

Pediatr Neurosurg. 2018;53(3):193-199. doi: 10.1159/000486202. Epub 2018 Feb 7.

Abstract

Background: The objective of this work is to present a review of all reports involving the management of unicoronal synostosis with distraction osteogenesis (DO). Also, we have innovated a new method in the treatment of cases of anterior plagiocephaly at a young age using DO.

Methods: We present a case in which anterior plagiocephaly was treated by DO of both metopic and hemicoronal sutures in a 4-month-old female patient. A comprehensive systematic literature review was completed using the search terms "distraction osteogenesis," "unicoronal synostosis," "anterior plagiocephaly," and "craniosynostosis." We excluded all experimental articles and reviewed clinical reports detailing the use of DO in the management of unicoronal synostosis.

Results: The study sample of this review consisted of 16 reports published over a period of 17 years that were analyzed in detail. The total number of patients treated by DO was 120, and the mean age at operation was 12 months. In the case presented, successful correction of the unicoronal synostosis was achieved.

Conclusion: Hemicoronal and metopic suture distraction in anterior plagiocephaly achieves considerable improvement in the midline shift of the anterior cranial base and naso-orbital complex.

Keywords: Anterior plagiocephaly; Craniosynostosis; Distraction osteogenesis; Unicoronal synostosis.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Cranial Sutures / surgery*
  • Craniosynostoses / surgery*
  • Female
  • Humans
  • Infant
  • Osteogenesis, Distraction / methods*
  • Plagiocephaly / surgery*
  • Skull / surgery