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TitleCraniosynostosis and Non-Synostotic Plagiocephaly
PurposeReview of 2 relatively common craniofacial malformations; give an overview of the pathophysiolygy, diagnosis and surgical/conservative treatment
ConclusionCraniosynostosis is a craniofacial malformation in which 1 or more cranial sutures are prematurely fused. It can be syndromic or isolated; syndromic children are generally more severely affected and can have multiple other malformations. Recurrence rate is higher for syndromic craniosynostosis; gene mapping has resulted in defining the mutated gene in many syndromes. Diagnosis is made clinically and based on CT scan (with 3D reconstruction) findings. The child has to be evaluated for other anomalies; review of family history and pedigree are extremely important, including prenatal history. Treatment is surgical before the age of 1,5 years to provide space for the growing brain, to avoid the complications of high intracranial pressure and to obtain the best aesthetic results. In syndromic cases, the rest of the face can be affected and this has to be evaluated and treated separately. Because of associated problems with feeding, breathing, speech development and craniofacial growth, these children are best followed and treated until adulthood by an experienced multidisciplinary craniofacial team.
Non-synostotic plagiocephaly is a deformational disorder, where the head has an abnormal shape caused by nondisruptive mechanical forces; it can arise in utero due to head constraint or postnatal due to head preference position of the infant. Diagnosis is made clinically and with plain X-ray. It is seen very frequently due to the “back to sleep” campaign. Treatment is conservative with physiotherapy or helmet molding in severe cases before the age of 1 year.
Author 1
Last nameROCHE
InitialsNA
DepartmentUniversity Hospital, Dept of Plastic and Reconstructive Surgery
CityGent
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