Posterior cranial vault distraction is recognized as a viable initial approach to patients with syndromic craniosynostosis. It offers advantages to initial anterior vault surgery and to traditional 1-stage advancements. Reports of posterior vault distraction have thus far focused on the use of standard titanium distractors. We present a case of posterior vault distraction with resorbable distraction devices, obviating the need for a second surgery and anesthetic for distractor removal. Distraction was performed successfully without complications or device-related issues.
The combination of specialized rigid fixation plates, allograft, tongue-and-groove locking osteotomies, and bone morphogenic protein was found to be safe and effective in preventing significant surgical relapse even after significant maxillary advancements.
Dermoid cysts are common periorbital lesions. They usually present early in life as mobile, palpable, well-circumscribed masses near the lateral brow. Transcranial extension of a superficial, nonmidline, periorbital dermoid cyst is rare. We report 2 cases of dermoid cysts of the lateral brow that were originally recognized during the newborn period. Over time, they appeared to be clinically resolved, but they presented years later with full-thickness bone erosion and transcranial extension. Excision was performed via a combined extracranial and intracranial approach. The treatment, pathophysiology, and natural history of orbitofacial dermoid cysts are reviewed.
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