Novel Method of Lateral Vault Modification in Scaphocephaly

Abstract

Background: Scaphocephaly is the commonest from of craniosynostosis. There are several surgical methods to correct this and is influenced by the areas affected. A common thread in any of these corrections is an attempt to increase the biparietal diameter by modifying the lateral vault panel (LVP). A simple and novel method is proposed. Materials and Method: The records of all patients undergoing scaphocephaly correction in the craniofacial unit at the institution were reviewed from 2003 to 2019. There were 106 patients, 57 males, and 49 females. The age ranged from 6 months to 5 years with a mean of 11 months. The method of vault remodeling was LVP only in 36 (34%), subtotal vault remodeling in 59 (56%), and total vault remodeling in 11 (10%). All 106 patients underwent LVP remodeling as part of the procedure. One or 2 wedge excisions was performed to increase the curvature of the LVP and this panel was fixed on the outside of the temporal squame bone. Results: The patients were followed up for a minimum of 1 year. Satisfactory results were obtained. The mean preoperative cephalic index was 64% and the mean postoperative index was 75%. There were minor complications such as screw visibility in a few patients. Conclusions: Wedge excisions of the LVP is a simple and effective maneuver that can be used as strategy when performing scaphocephaly correction.