Bilateral Coronal Synostosis

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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Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

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