Spring-Assisted Distraction Osteogenesis for the Treatment of Shunt-Induced Craniosynostosis

Yufan Yan, Jonathan T. Bacos, Arthur J. DiPatri, Arun K. Gosain*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Shunt-induced craniosynostosis is a rare complication of ventricular shunting for hydrocephalus in pediatric patients. Although the exact pathophysiology of this form of secondary craniosynostosis is not well understood, the current understanding is that persistent drainage of the ventricular shunt causes decreased dural tension, resulting in decreased expansile force on the cranium and premature sutural fusion. Due to the low incidence of this complication, there is no consensus on the ideal treatment for shunt-induced craniosynostosis. In recent years, distraction osteogenesis has been employed with greater frequency, as it is felt to counter the fundamental problem of decreased expansile force on the cranium. However, in a patient with a ventricular shunt, placement of external hardware in close proximity to the shunt could cause significant morbidity due to the increased risk of shunt infection. We present the management of a patient with shunt-induced craniosynostosis who continued to be shunt-dependent. We chose to use fully buried springs to create an expansile force on the cranium as an alternative to external distractors so as to mitigate the risk of infection. We demonstrate that spring-assisted distraction osteogenesis can be an effective treatment modality for patients with shunt-induced craniosynostosis. This method should be considered in patients with contraindications to external distraction devices, such as ongoing shunt dependency.

Original languageEnglish (US)
Pages (from-to)1336-1339
Number of pages4
JournalCleft Palate-Craniofacial Journal
Volume57
Issue number11
DOIs
StatePublished - Nov 1 2020

Keywords

  • distraction osteogenesis
  • scaphocephaly
  • secondary craniosynostosis
  • shunt-induced craniosynostosis
  • spring cranioplasty
  • spring-assisted distraction osteogenesis
  • ventriculoperitoneal shunt

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology

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