Craniosynostosis forehead reconstruction using sagital bony bar (case report)

Abstract

A four years old boy was referred to Ibn-Sina Teaching hospital / Mosul city complaining from deterioration of vision 2 months ago, which was documented by an ophthalmological examination. A medical cranial imaging was taken; it showed fusion of sagital, coronal and metopic sutures with diffused beaten copper appearance. The patient was admitted to the neurosurgical department, a measurement of intracranial pressure via lumbar puncture and cerebrospinal fluid manometry showed a 340 mm CSF reading which is very high. Surgery was planned by a neurosurgical and maxillofacial surgical team. Under general anesthesia, a bi-coronal flap was raised, incision and removal of a wide bony bar along the closed sagital cranial suture and the skull bone was released by nibbling. The eye balls were separated from the orbital bones, the anterior part of orbital roof was removed; the flatted forehead was removed and reconstructed by using the bone that was removed from the sagital area and fixed in its new place by titanium plates and stainless wire. The postoperative course was uneventful and the child's visual acuity returned to a normal condition dramatically. Follow up for three years showed normal cranial growth, normal vision and no medical complications that may be related to the surgical operation