A Late Result of an Early Operation for Unilateral Coronal Synostosis

2003 ◽  
Vol 38 (6) ◽  
pp. 334-337
Author(s):  
Joseph H. Piatt, Jr. ◽  
Joseph A. Iocono
Keyword(s):  
Late Result ◽  
Early Operation ◽  
Coronal Synostosis

P100 Removing the orbital bar in fronto-orbital advancement and reconstruction

2019 ◽  
Vol 90 (3) ◽  
pp. e48.3-e49
Author(s):  
A Sheikh ◽  
M Schramm ◽  
P Carter ◽  
J Russell ◽  
M Liddington ◽  
...  
Keyword(s):  
Bone Graft ◽  
Retrospective Analysis ◽  
Frontal Bone ◽  
Cosmetic Results ◽  
Absorbable Sutures ◽  
Radiological Images ◽  
Coronal Synostosis ◽  
Excellent Source

ObjectivesTo describe our technique of using reverse frontal bone graft for FOAR for patients with metopic or coronal synostosis.DesignRetrospective analysis of digital records for operation notes and radiological images.SubjectsSince April 2014, 16 patients underwent FOAR without using orbital bar.MethodsWe plan a frontal bone graft using Marchac template and increase the angles on side by 1 cm. This graft is then reversed and supra orbital margins are drilled out. The orbital bar is then removed and drilled down to make bone dust which is then used to fill gaps on exposed dura. The reversed frontal graft is then placed in front and secured via absorbable sutures, plate and screws.ResultsAll 16 patients who underwent this technique have shown excellent cosmetic results with no complications or non healing. Removing orbital bar does not cause any cosmetic defect since orbital rims are drilled out in reverse frontal bone graft. The removed orbital bar provides an excellent source of bone dust to cover gaps on exposed dura.ConclusionsWe present our technique of FOAR without using orbital bar, which is drilled down to bone dust to fill gaps. This has shown excellent cosmetic results so far with no complications. This addresses the issue of temporal thinning.

Osteoblast-Directed Osteoclast Metabolism from Patients with Premature Coronal Synostosis

1997 ◽  
Vol 99 (6) ◽  
pp. 1518-1521 ◽  
Author(s):  
Jay M. Pensler ◽  
Pravin-Kumar Patel ◽  
Craig B. Langman
Keyword(s):  
Coronal Synostosis

Development of secondary unilateral coronal suture synostosis with a sagittal suture synostosis in a nonsyndromic patient

2012 ◽  
Vol 9 (2) ◽  
pp. 116-118 ◽  
Author(s):  
Leonardo Rangel-Castilla ◽  
Steven W. Hwang ◽  
Andrew Jea ◽  
William E. Whitehead ◽  
Daniel J. Curry ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Early Stage ◽  
Sagittal Synostosis ◽  
Clinical Appearance ◽  
Syndromic Craniosynostosis ◽  
Intervention Failure ◽  
Frontoorbital Advancement ◽  
Coronal Synostosis ◽  
Second Procedure

Multiple-suture synostosis is typically associated with syndromic craniosynostosis but has been occasionally reported in large series of nonsyndromic children. The diagnosis of multiple fused sutures usually occurs at the same time, but rarely has the chronological development of a secondary suture synostosis been noted. The development of secondary bicoronal suture synostosis requiring surgical intervention has only been reported, to date, after surgical intervention and is hypothesized to arise from a disruption of inhibitory factors from the dura. The disinhibition of these factors permits the sutures to then fuse at an early stage. The authors report on a patient who developed secondary unilateral coronal synostosis after the diagnosis of an isolated sagittal synostosis. The secondary synostosis was identified at the time of the initial surgical intervention and ultimately required a second procedure of a frontoorbital advancement. The clinical appearance of this phenomenon may be subtle, and surgeons should monitor for the presence of secondary synostosis during surgery as it may require intervention. Failure to identify the secondary synostosis may necessitate another surgery or result in a poor cosmetic outcome. The authors recommend close clinical follow-up for the short term in patients with isolated sagittal synostosis.

scholarly journals AN INSTRUCTIVE FATAL CASE OF APPENDICITIS WITH ADVOCACY OF EARLY OPERATION.

The Lancet ◽  
1909 ◽  
Vol 173 (4476) ◽  
pp. 1682-1683
Author(s):  
J.S. Boden ◽  
EdredM. Corner
Keyword(s):  
Fatal Case ◽  
Early Operation

scholarly journals Outcomes of endoscopic suturectomy with postoperative helmet therapy in bilateral coronal craniosynostosis

2016 ◽  
Vol 18 (3) ◽  
pp. 281-286 ◽  
Author(s):  
S. Alex Rottgers ◽  
Subash Lohani ◽  
Mark R. Proctor
Keyword(s):  
Hospital Stay ◽  
Head Circumference ◽  
Major Complication ◽  
Csf Leak ◽  
Perioperative Morbidity ◽  
Syndromic Craniosynostosis ◽  
Duration Of Surgery ◽  
Coronal Synostosis ◽  
The Mean

OBJECTIVE Historically, bilateral frontoorbital advancement (FOA) has been the keystone for treatment of turribrachycephaly caused by bilateral coronal synostosis. Early endoscopic suturectomy has become a popular technique for treatment of single-suture synostosis, with acceptable results and minimal perioperative morbidity. Boston Children's Hospital has adopted this method of treating early-presenting cases of bilateral coronal synostosis. METHODS A retrospective review of patients with bilateral coronal craniosynostosis who were treated with endoscopic suturectomy between 2005 and 2012 was completed. Patients were operated on between 1 and 4 months of age. Hospital records were reviewed for perioperative morbidity, length of stay, head circumference and cephalic indices, and the need for further surgery. RESULTS Eighteen patients were identified, 8 males and 10 females, with a mean age at surgery of 2.6 months (range 1–4 months). Nine patients had syndromic craniosynostosis. The mean duration of surgery was 73.3 minutes (range 50–93 minutes). The mean blood loss was 40 ml (range 20–100 ml), and 2 patients needed a blood transfusion. The mean duration of hospital stay was 1.2 days (range 1–2 days). There was 1 major complication in the form of a CSF leak. The mean follow-up was 37 months (range 6–102 months). Eleven percent of nonsyndromic patients required a subsequent FOA; 55.6% of syndromic patients underwent FOA. The head circumference percentiles and cephalic indices improved significantly. CONCLUSIONS Early endoscopic suturectomy successfully treats the majority of patients with bilateral coronal synostosis, and affords a short procedure time, a brief hospital stay, and an expedited recovery. Close follow-up is needed to detect patients who will require a secondary FOA due to progressive suture fusion or resynostosis of the released coronal sutures.

The Development and Early Operation of Clinical Commissioning Groups (CCGs)

2020 ◽  
pp. 35-48
Author(s):  
Anna Coleman ◽  
Imelda McDermott ◽  
Lynsey Warwick-Giles ◽  
Kath Checkland
Keyword(s):  
Early Operation
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