Distraction Osteogenesis Technique for the Treatment of Nonsyndromic Sagittal Synostosis.

Sagittal synostosis is the most common form of isolated, nonsyndromic craniosynostosis, accounting for more than half of all the craniosynostosis cases.1–3 Traditionally, sagittal craniosynostosis has been surgically managed by open cranial vault reconstruction. More recently, endoscopic-assisted strip craniectomy with postoperative helmet molding has been used effectively in children younger than 6 months old.4–6 The surgical treatment of delayed presentation of sagittal synostosis has largely been limited to open vault reconstruction. Although excellent cosmetic outcomes and resolution of intracranial hypertension are obtained, there are drawbacks including long operative times, high volume blood loss, and a high incidence of persistent postoperative cranial vault bony defects.7–10 To avoid the morbidities associated with open vault reconstruction, surgical correction using internal distraction osteogenesis has been explored. The majority of previous studies evaluated the effectiveness of distraction osteogenesis in the setting of multiple suture synostosis.11–17 Limited information has been published concerning the use of distraction osteogenesis for the treatment of isolated sagittal synostosis.18,19 In this report, we describe the successful management of delayed presentation of sagittal synostosis using our distraction osteogenesis technique. The technique was designed so that the anterior and posterior vault expansion can be individualized to specific patient needs to obtain a normal head shape.