Turkish Neurosurgery 2011 , Vol 21 , Num 3
The Surgical Treatment of Plagiocephaly
Gokalp SILAV1, Gulden AVCI2, Mithat AKAN3, Gaye TAYLAN4, Ilhan ELMACI1, Tayfun AKOZ4
1Acibadem University, Faculty of Medicine, Department of Neurosurgery , Istanbul, Turkey
2Canakkale Onsekiz Mart University, Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Canakkale, Turkey
3M. H. Istanbul Okmeydani Education and Research Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Istanbul, Turkey
4M. H. Kartal Dr. Lutfi Kirdar Education and Research Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.4095-11.1 AIM: Anterior plagiocephaly usually occurs with premature synostosis of the ipsilateral half of the coronal suture. The forehead is flattened on the affected side, with a backward and upward displacement of the affected orbit. The bulging of the calvaria may occur in the contralateral parietal area.

MATERIAL and METHODS: This article presents the surgical techniques used over 7 years to treat plagiocephalic children. Eleven patients with unilateral coronal synostosis treated during 2003-2010 were analyzed retrospectively. The study included reviews of pre and postoperative computed tomography scans, operative techniques, clinical outcomes and complications. Unilateral orbital advancement with “tongue in groove” was performed in 5, and bilateral orbital advancement in 6 cases. Pre and postoperative anthropometric measurements were used to document the amount of advancement of the elevated and recessed orbita, and the amount of withdrawal of the contralateral side.

RESULTS: The mean age of the patients at time of surgery was 11 months. The preoperative values of the orbital height and retrusion were 0.68 cm and 1.87 cm, respectively. They were recorded as -0.1cm and 0,63 cm, postoperatively. Mean follow-up was 36 months, neither neurological sequelae nor other significant complications were encountered.

CONCLUSION: The surgical corrections have resulted in significant improvements in skull shape and high patient/parent satisfaction. Keywords : Plagiocephaly, Unilateral, Coronal synostosis, Fronto-orbital advancement

Corresponding author : Gulden Avcı, drguldenavci@hotmail.com