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Vol. 6. Issue 3.
Pages 189-195 (January 1995)
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Vol. 6. Issue 3.
Pages 189-195 (January 1995)
Escafocefalia. Parte I: Diagnóstico y resultados en el tratamiento quirúrgico de 86 pacientes
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J. Esparza, F. Cordobés, M.J. Muñoz, R. Salván, A. Benítez
Servicios de Neurocirugía Pediátrica. Hospital Universitario “12 de Octubre”
A. Muñoz*, J. Caretti**
* Servicios de Cirugía Craneofacial, Neurorradiología. Hospital Universitario “12 de Octubre”
** Servicios de Anestesia y Reanimación. Hospital Universitario “12 de Octubre”
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Resumen

Se revisan 86 niños tratados de escafocefalia en un período de tiempo que abarca desde 1983 hasta 1994, representando el 47,51% de los 181 casos de craneosinostosis y sinostosis craneofaciales de la serie de nuestro Servicio. La edad osciló entre los 2 y 24 meses, con una edad media de 4,8 meses. Ninguno de los niños tuvo afectación neurológica y en 9 de los 10 casos en que se monitorizó la presión intracraneal (PIC), ésta fue normal. Dependiendo de la técnica quirúrgica empleada, los casos se han dividido en cuatro diferentes grupos de enfermos. En trece niños se realizó una craniectomía lineal parasagital bilateral con interposición de material plástico. En 8 pacientes se practicó una amplia craniectomía sagital interfontanelar. Cinco niños por su mayor edad fueron tratados mediante transposición de amplios colgajos. En el último grupo, “60 niños (69,7%) fueron tratados con una técnica quirúrgica que consigue la «correción inmediata» de la deformación en el mismo acto quirúrgico. Con esta última técnica se consiguieron unos resultados muy superiores a los de las previas.

Palabras clave:
Craneoestenosis
Craneosinostosis
Craniectomía
Escafocefalia
Sinostosis sagital
Summary

A series of 86 children with scaphocephaly diagnosed and treated between 1983 and 1994 are reviewed. They represented a 47,5% out of 181 patients having craniosynostosis and craniofacial synostosis in our Craniofacial Unit. Their ages ranged between 2 and 24 months (mean age. 5,8 months).

All the patients had normal neurologic examination and intracranial pressure monitoring was performed in ten children, pressure being within normal ranges in aIl but one patient.

The patients were classified in four groups according to the operation employed to correct the malformation. Thirteen children were treated through a bilateral parasagittal strip craniectomy with interposition of plastic material. In 8 patiens a wide sagittal interfontaneIlar craniectomy was performed. Five patients in the older age range were treated by performing a complex transposition of great oseous flaps. Sixty patients had an special surgical technique of multiple fragmentation and skulI resection that achieve an inmediate correction of the malformation. This last technique resulted in an earlier and better cosmetic results.

Key words:
Craniosynostosis
Craniectomy
Sagittal suture
Schaphocephaly

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