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Craniosynostosis - Causes, Diagnosis, Treatment
Craniosynostosis - Causes, Diagnosis, Treatment
The term "craniosynostosis" means the premature fusion of cranial sutures. Craniosynostosis usually manifests itself at birth, but not always, especially with moderate flow. The most common manifestations of craniosynostosis start out as a deformation in the first months of life. In addition to the cosmetic defect, craniosynostosis may lead to increased intracranial pressure and adverse effects on child development.
Normal development of the skull
In the adult skull is normally composed of 28 bones. The flat bones that form the cranial vault, are interconnected joints.
At birth, the baby's skull is made up of 45 separate bony elements. With the growth of many of these elements are fused into a single bone (eg, frontal bone, which at birth is composed of two parts).
The bones of the cranial vault was originally divided into areas of dense connective tissue. At birth these regions are composed of fibrous tissue and are mobile, the need for a newborn and further development. Over time, areas of connective tissues ossify.
There are two types of classification of craniosynostosis: clinical manifestations and, accordingly, the affected cranial suture.
Scaphocephaly - a premature fusion of the sagittal suture.
Plagiocephaly - the premature fusion of coronal suture.
Trigonotsefaliya - the premature fusion of metopic (frontal) suture.
Terms brachycephaly, and oksitsefaliya turritsefaliya used to refer to various forms of synostosis, in which affected different joints of the skull.
The Causes for craniosynostosis
The Causes for craniosynostosis is still not completely known, but is now considered the basic genetic theory of craniosynostosis. These genetic abnormalities of the skull found at the three syndromes: Crouzon, Apert, and Pfeiffer.
The manifestations of craniosynostosis
In addition to the most visible deformation of the head and face with craniosynostosis may occur when problems with the respiratory tract, especially in the form of syndromic craniosynostosis. In view of the underdevelopment of the maxilla in these patients have difficulty in nasal breathing. At night they may have periods of "apnea" - breath-holding. This affects not only their development but also on the behavior and speech. With increased intracranial pressure in children observed a chronic headache, develop mental disorders, blurred vision. As the child's apparent deformity of the skull has a negative impact on his social adaptation and self-esteem.
It is much to say about states that are similar to craniosynostosis. This is called positional plagiocephaly. It is a flattening or distortion of certain areas of the skull. While this may be a similarity with the external craniosynostosis, it is important to distinguish between these states. The fact that positional plagiocephaly does not require surgical treatment. Treatment of this disease is simple and it is laying in a baby's head during sleep, in some cases may need a special skull "bandage", worn on the head of the child to correct the skull shape.
Diagnosis of craniosynostosis
Diagnosis of this disease is primarily a medical examination, as well as in carrying out X-ray of the skull. In addition, methods such as computed tomography and magnetic resonance imaging.
Treatment of craniosynostosis
When craniosynostosis is usually surgical treatment. It is to separate prematurely fused sutures and reconstruction of the skull shape. Often cosmetic problems requiring co-treatment with your dentist.
Surgical treatment is to conduct a zigzag incision from one ear to the other through the top of the head. The use of this type of cut due to the fact that the scar left after a cut, allows hairline look more natural. To stop the bleeding in this section are used clips of Leroy. After cutting a flap of skin (scalp) leans back. In the skull carried out the hole. Through these holes the bones of the skull as if sawn, which allows you to divide it into several parts. Once the surgeon has recreated the shape of the skull, the skull laid back (usually in a different configuration, ¬), and are joined together absorbable sutures, plates and screws. Plates and screws are made of special polymers that are absorbed through the year to form water and carbon monoxide. Often, to restore the bone defect after an operation applied demineralized bone grafts. After removal of the hemostat skin incision sutured.
Currently, there are new methods of treating craniosynostosis using endoscopic techniques. They are characterized by significantly less bleeding, swelling, pain and time spent in hospital. However, this method of treatment is shown only to children younger than 6 months. For older children need more intensive treatment.
