Bilateral coronal synostosis causes restricted antero-posterior growth of the skull. Compensatory growth occurs at the metopic, sagittal and squamosal sutures, which increases the height of the skull and results in turribrachy-cephaly (Fig. 25.4a). Surgery must shorten the protracted cranial height and expand the restricted orbito-frontal region.
To decrease the skull height and increase its antero-posterior dimension, a near calveriec-
tomy is required (Fig. 25.4b). In the modified prone position, a bi-frontal craniotomy is fashioned, removing the flap as a single unit. A similar bi-parieto-occipital flap is performed, leaving only the sagittal suture and two parietal struts between the anterior and posterior craniotomies. The anterior and posterior cran-iotomies are refashioned using radial osteotomies and controlled fractures. The remaining occipital bone is out-fractured using barrel-stave osteotomies, expanding the skull posteriorly. Bilateral orbital rim advancements are
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.