Scaphocephaly, also known as Sagittal Synostosis, is a form of orthopedic cranial (skull) disorder. This condition causes the sagittal suture to close prematurely which leads to the deformation of the skull. A child affected with Scaphocephaly has a head which seems to be elongated from the front and back with the sides closer to each other than is normal. The head is similar to the keel of a beat.
The Sagittal suture is a long gap situated on top of the head. It starts at the front of the head, just above the forehead, and continues from the middle to the back of the skull. When this suture closes too soon due to natural development then it causes the head to become elongated from the front and the back and squeezes the sides of the head closer. This results in the head resembling the keel of a boat.
The abnormal elongation of the head is the result of premature closing of the Sagittal suture. This condition is mostly seen in premature babies and is not the result of any other underlying condition. This condition arises due to premature fusion (closing) of the Sagittal suture on the top of the head which leads to the distinct elongation of the head.
The most noticeable symptom of Scaphocephaly is the abnormal elongation of the head of the baby. The skull also shows distinct ridges of the Sagittal suture.
Often the soft spot normally seen in newborns is not present in these conditions. The ridge on top of the skull can be seen and felt quite clearly. The skull seems stretched from front to back which caused the sides to come closer than normal. This also results in a prominent forehead and narrow sides of the skull.
The initial form of diagnosing Scaphocephaly is a physical examination of the newborn’s skull when it shows signs of being abnormal in shape. This is either noticed during the birth or as the bay starts to grow.
If the doctor feels there is a chance of Scaphocephaly being the cause of the abnormality then the doctor may also advise certain radiography tests of the skull, such as MRI (magnetic resonance imaging) scan, CT (computerized tomography) scans and skull x-rays to confirm the diagnosis from the physical examination.
Surgery is the most ideal option for correcting the skull deformity caused by Scaphocephaly. There are mainly two types of surgical approaches that can be used to treat this condition.
If the baby is less than 4 months of age then the doctor is likely to use the minimally invasive (endoscopic) strip Craniectomy. This procedure needs a few small incisions on both ends of the Sagittal suture. The surgeon will use these small incisions to remove a small piece (strip) of bone which includes the prematurely closed Sagittal suture as well. Other wedges of bones are also removed from the back and front of the Sagittal suture. The removed bone wedges allow space for the parietal bones of the skull to move easier.
This surgical procedure helps to remove the constriction of the skull bone and allows for natural and normal skull growth.
For babies older than 4 months of age the open cranial vault remodeling is considered as an ideal surgical treatment. As the bones of the skull in a child older than 4 months tend to get stiff it gets difficult to acquire the desired changes through strip Craniectomy. There are various different approaches for performing open cranial vault remodeling, although the main aims and the steps in the procedures remain the same.
The open cranial vault remodeling surgery ideally requires a long incision from one ear to the other ear at the back. The doctor will gently remove the bones of the skull that are causing the abnormal shape and restricting the growth of the skull in a normal manner. The doctor will then gently manipulate the skull bones of the Sagittal suture. The corrected skull bones are then re-attached using dissolvable sutures which help stabilize the bones till they fuse (heal/join) naturally.
The main aim of this form of Scaphocephaly treatment surgical method is to restore the normal shape and size of the skull from the back and the front.
Scaphocephaly is one of the common cranial disorders seen in newborns especially premature babies during birth or in the developmental stage of the head in the first year of their life. Surgery can help to treat Scaphocephaly successfully.
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