Journal of Craniofacial Surgery Presents Update on Craniosynostosis

Ongoing progress in the care of children with a type of skull deformity called craniosynostosis is highlighted in the special January issue of The Journal of Craniofacial Surgery. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

The twenty articles in the special issue present advances and updates in a wide range of topics concerned with the assessment, reconstructive surgery, and long-term follow-up of children with craniosynostosis. "Craniosynostosis" refers to various conditions in which the joints (sutures) between the bones of the skull close prematurely, resulting in abnormal growth of the skull and brain. Craniofacial surgeons, in concert with other professionals, design effective treatments to correct the skull deformity, prevent complications, and promote good long-term functioning.

High-Tech Advances
Topics in the special issue include new approaches to evaluation and measurement of skull deformities caused by craniosynostosis and related conditions. Recent advances include the use of three-dimensional virtual reality displays and "stereolithographic" models created using data from computed tomography (CT) scans, for use in treatment planning. Innovative surgical techniques for managing specific forms of craniosynostosis, including rare deformities, are presented as well.

A new frontier is the development of advanced surgical techniques and materials. One paper describes initial experience with a new synthetic material as an alternative to bone grafts; promising results with a tissue-engineered "osteogenic" (bone-producing) material are reported as well. Another study demonstrates that high-tech advances can have benefits on the human scale: newer "minimally invasive" approaches to surgery are shown to reduce the high stress levels experienced by parents of children with craniosynostosis.

After these extremely complex surgeries, careful follow-up is essential to ensure appropriate good form and function of the reconstructed skull as the child grows. One paper highlights the need for close monitoring for signs of visual damage related to excess pressure within the skull.

Positional Plagiocephaly
Several papers address a separate problem called positional plagiocephaly—flattening of the back of the skull in infants. Positional plagiocephaly is a much less serious condition than craniosynostosis, but has been more frequent since the recommendation to lay babies on their backs to sleep to prevent sudden infant death syndrome (SIDS). In most cases, plagiocephaly is treated using a special helmet to help "mold" the growing skull. A new study adds to research demonstrating the good results of molding helmet therapy, with high parental satisfaction rates and good quality-of-life scores.