Re-imagining early cloverleaf skull deformity management from front to back approach—30 years on
Issued Date
2023-01-01
Resource Type
ISSN
02567040
eISSN
14330350
Scopus ID
2-s2.0-85171201588
Pubmed ID
37698651
Journal Title
Child's Nervous System
Rights Holder(s)
SCOPUS
Bibliographic Citation
Child's Nervous System (2023)
Suggested Citation
Moore M.H., Chaisrisawadisuk S., Khampalikit I., Doorenbosch X., Jukes A., Molloy C.J. Re-imagining early cloverleaf skull deformity management from front to back approach—30 years on. Child's Nervous System (2023). doi:10.1007/s00381-023-06147-0 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/90144
Title
Re-imagining early cloverleaf skull deformity management from front to back approach—30 years on
Author's Affiliation
Other Contributor(s)
Abstract
The cloverleaf skull deformity remains among the most complicated craniofacial conditions to successfully manage. Many cases achieve largely unsatisfactory outcomes due to the requirement for frequent reoperation on the cranial vault and failure to deal with all the elements of the craniofaciostenosis in a timely fashion. Early cranial vault surgery without addressing the cranial base deformity and its attendant cerebrospinal fluid flow changes is invariably challenging and disappointing. A recent focus on the expansion of the posterior cranial vault as a primary procedure with the greater volume change allows a delay in fronto-orbital advancement and reduced need for repeat surgery. We herein describe three cases of complex multisuture craniosynostosis with cloverleaf skull deformity who underwent neonatal posterior cranial vault decompression along with foramen magnum decompression. Our report examines the safety and rationale for this pre-emptive surgical approach to simultaneously deal with the cranial vault and craniocervical junction abnormalities and thus change the early trajectory of these complex cases.