Cranial Compression by Reverse Distraction: A New Technique for Correction of Sagittal Synostosis

Complete Correction of Severe Scaphocephaly: The Melbourne Method of Total Vault Remodeling

“…Despite its limitations, the cranial index provides a gross assessment of dimensional change, and our results compare very favorably with other reported series 15,16,18,21,22,27 (Table 1), with an average in- Fig. 8.…”

“…Where other centers have focused on measuring cranial index changes 15,16,18,21,22 in the reporting of results, a normal cranial index alone does not necessarily reflect a normal head shape, and stigmata of the deformity will remain apparent if excessive frontal bossing, occipital "bulleting," and the anteriorly located vertex persist. Despite its limitations, the cranial index provides a gross assessment of dimensional change, and our results compare very favorably with other reported series 15,16,18,21,22,27 (Table 1), with an average in- Fig.…”

“…The pi procedure does not directly address the occipital or frontal deformities, and concerns have been expressed about the risk of brain compression that may raise intracranial pressure, and some advocate intraoperative pressure monitoring. 21,22 In an attempt to achieve more gradual anteroposterior shortening and reduce the risk of raised pressure, Greensmith et al 22 used a modified pi pattern osteotomy with a distraction device applied fully open to achieve gradual anteroposterior shortening with secondary biparietal expansion. Good initial results were reported in this small series from another institution, but this technique does not address the problems of frontal bossing and the bullet-shaped occiput seen in more severe deformities.…”

Cranial Compression Using Distractors in Reverse Fashion as an Alternative Method for Correcting Scaphocephaly in Older Patients

“…In scaphocephaly cases, distraction osteogenesis has been used to laterally expand the temporoparietal bone [25]. Greensmith et al [4] treated 3 scaphocephaly patients with gradual cranial compression with a distractor in the anteroposterior length. Matsumoto et al [5] treated a case of scaphocephaly by both increasing the skull width with a distraction device and decreasing the anteroposterior length with a contraction device.…”

“…To overcome these problems, gradual cranial compression via a distractor has been introduced for the correction of the various manifestations of craniosynostosis. Greensmith et al [4] have reported some promising outcomes for cranial compression with a distractor to correct sagittal craniosynostosis. Matsumoto et al [5] and Komuro et al [6] have reported the efficacy of a modified technique involving simultaneous distraction and contraction.…”