Craniosynostosis is a condition in which one or more of the fibrous sutures in an infant skull prematurely fuses by ossification, thereby changing the growth pattern of the skull. Because the skull cannot expand perpendicular to the fused suture, it compensates by growing more in the direction parallel to the closed sutures. The resulting growth pattern provides the necessary space for the growing brain, but results in an abnormal head shape and sometimes abnormal facial features. In cases in which the compensation does not effectively provide enough space for the growing brain, craniosynostosis results in increased intracranial pressure leading possibly to visual impairment or an impairment of mental development combined with a significant reduction in IQ.
Trigonocephaly is a result from the premature closure of the metopic suture. Using Virchow’s law again to predict the resulting deformity, this fusion will result in a narrow forehead, which is even further emphasized by ridging of the suture. Compensatory growth occurs at both the coronal sutures, thereby pushing the forehead forwards. The resulting shape can best be assessed from a top view again, which will reveal a somewhat triangular form of the head. Trigonocephaly is also a Greek derived word, which can be translated as triangular shaped head. A facial feature of metopic synostosis is hypotelorism; in the frontal view, it can be seen that the width between the eyes is smaller than usual
The aims of surgery are to allow normal brain growth by providing an adequate space within the skull. The ideal time for surgery, is usually between three to six months of age because bones of the skull are easy to work with at that age, and the covering of the brain, known as the dura, can make bone on its own. Early surgery also provides the growing brain with the ideal surroundings and facilitates normal future shaping of the skull. Although surgery is done early in life, there is no upper age limit for surgery. Usually, one surgery is required to correct children with simple craniosynostosis; however, some may need minor alterations at the age of four or five.
(Incision from the top of the ear
to the top of the ear)
Aliyah is getting the Traditional surgery for craniosynostosis, which is usually performed via a bicoronal skin flap (across the top of the head from ear to ear). A generous craniectomy to "reopen" the prematurely fused sutures with extension to the adjacent sutures, in addition to restructuring or remodeling of the involved skull bones when required, is the basic procedure.
Cranial Molding Helmet
The cranial helmet is used to remold the head into a symmetrical shape as the baby grows. It allows the flattened areas to round out and prevents the bulging areas from bulging more. The helmet does not put pressure on the baby’s head, but rather guides the growth to specific areas to improve the head shape. It is very important to start treatment early since the growth of the head slows down after the age of 12 months. Usually the earliest an infant can start wearing a helmet is at 5 months. Infants younger than that typically do not have the appropriate strength in the neck and head muscles to control the movements of the head. It is also important for the baby to be screened for other conditions that may have caused the uneven head growth.
