Occipital remodeling and suboccipital decompression in severe craniosynostosis associated with tonsillar herniation

Neurosurgery
G CinalliD Renier

Abstract

The goal was to describe a surgical technique allowing occipital vault remodeling and suboccipital decompression in patients affected by multiple-suture synostosis presenting severe occipital flattening and chronic tonsillar herniation (CTH). Four patients (two with Crouzon's syndrome, one with Kleeblattschädel, and one with complex craniosynostosis) presenting multiple-suture synostosis with severe occipital flattening, posterior fingerprint impressions, and CTH were operated on in the prone position. For three patients, occipital vault remodeling and suboccipital decompression without dural opening were performed; for one patient affected by Kleeblattschädel, an upper cervical laminectomy and dural opening were performed. All patients were studied with magnetic resonance imaging pre- and postoperatively. No complications were observed. In all cases, postoperative magnetic resonance imaging revealed good decompression of the craniocervical junction, with resolution of brain stem displacement. In one case, CTH recurred 15 months after surgery, although in a less severe form. In selected cases of complex or syndromic craniosynostosis with predominant posterior deformity and CTH, this technique was safe and useful in the manageme...Continue Reading

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Citations

May 29, 2004·The Journal of Craniofacial Surgery·Mirjam F HoefkensJ Michiel Vaandrager
Jun 5, 2012·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·J LeikolaV Koljonen
Sep 12, 2015·The Journal of Craniofacial Surgery·Irene M J Mathijssen
Jan 19, 2018·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Fatima Azahraa HaddadR Shane Tubbs
May 6, 2005·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Giuseppe CinalliDominique Renier
Feb 27, 2010·The Journal of Craniofacial Surgery·Adrianna RangerDamir Matic
Sep 3, 2011·Neurosurgical Focus·Jennifer StrahleCormac O Maher
Aug 9, 2012·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Daniel NowinskiEric Arnaud
Sep 26, 2012·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Caroline DriessenIrene M J Mathijssen
Jun 12, 2014·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Matthias SchulzUlrich-Wilhelm Thomale
Jul 23, 2016·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Francesco Giovanni SgulòGiuseppe Cinalli
May 27, 2016·Journal of Korean Neurosurgical Society·Jung Won ChoiHyung-Jin Shin
Apr 10, 2010·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Charles DavisAgadha Wickremesekera
Aug 9, 2012·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Guillaume CollFederico Di Rocco
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Nov 14, 2013·The Journal of Craniofacial Surgery·Enrico GhizoniCassio Eduardo Raposo-Amaral
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Jul 30, 2014·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Alper CesmebasiAaron A Cohen-Gadol
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May 3, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Stephen BordesR Shane Tubbs
May 31, 2021·Clinics in Plastic Surgery·Laura S HumphriesJesse A Taylor
Jun 30, 2021·Current Opinion in Otolaryngology & Head and Neck Surgery·Henya Sandhaus, Matthew D Johnson
Sep 17, 2021·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Valentina PennacchiettiUlrich-Wilhelm Thomale
Oct 5, 2021·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Bienvenido RosMiguel Ángel Arráez

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