Abstract
Background
Since its first description by Virchow, the principle of abnormal skull growth due to restriction of skull growth at the fused sutures, and the realisation by Moss that the sutures at the skull base are equally affected, have been the main intellectual driving forces behind the majority of cranial expansion procedures performed currently in children with craniosynostosis.
Current observations
Despite original impressions that craniosynostosis leads to craniostenosis, many studies have demonstrated that in the majority of patients with craniosynostosis there is normal skull volume in those over the age of 6 months. In Apert syndrome, skull volume is invariably larger than normal. Some studies have shown that intracranial pressure is independent of intracranial volume, and can exist in the presence of normal volume, or indeed after cranial expansion. These observations imply that cranial expansion procedures create a state of artificially increased skull volume, in the quest to improve appearance and function.
Future advances
This creates a new angle of view through which skull growth abnormalities are seen. It is becoming clearer that in most patients with craniosynostosis, there is regional imbalance of skull growth, which co-exists with a variety of other equally important factors, such as genetic defects, raised intracranial pressure, venous hypertension, and other brain parenchymal anomalies such as hindbrain hernia or hydrocephalus. It is becoming increasingly obvious that the type of surgical treatment currently practised in most cases is conceptually incorrect. Recent modifications such as the use of springs or distraction do not escape from the underlying philosophy of cranial expansion. With that in mind, it is hoped that advances in the fields of genetics and molecular biology will provide treatments for the cause of craniosynostosis rather than the symptomatic relief that surgery offers currently.
Conclusion
Until then, there is a need to develop better ways of quantifying regional abnormalities of skull growth.
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References
Abbott AH, Netherway DJ, Niemann DB, Clark B, Yamamoto M, Cole J, Hanieh A, Moore MH, David DJ (2000) CT-determined intracranial volume for a normal population. J Craniofac Surg 11:211–223
Abe H, Ikota T, Akino M, Kitami K, Tsuru M (1985) Functional prognosis of surgical treatment of craniosynostosis. Childs Nerv Syst 1:53–61
Apert E (1906) De l’acrocéphalosyndactylie. Bull Mem Soc Med Hop Paris 23:1310
Arnaud E, Renier D, Marchac D (1995) Prognosis for mental function in scaphocephaly. J Neurosurg 83:476–479
Avantaggiato A, Carini F, Curioni C (1996) Apert’s syndrome: cephalometric evaluation and considerations on pathogenesis. J Craniofac Surg 7:23–31
Buda FB, Reed JC, Rabe EF (1975) Skull volume in infants. Methodology, normal values and application. Am J Dis Child 129:1171–1174
Campbell JW, Albright AL, Losken HW, Biglan AW (1995) Intracranial hypertension after cranial vault decompression for craniosynostosis. Pediatr Neurosurg 22:270–273
Carinci F, Avantaggiato A, Curioni C (1994) Crouzon syndrome: cephalometric analysis and evaluation of pathogenesis. Cleft Palate Craniofac J 31:201–209
Carmel PW, Luken MG, Ascherl GF (1981) Craniosynostosis: computed tomographic evaluation of skull base and calvarial deformities and associated intracranial changes. Neurosurgery 9:366–372
Carr M, Posnick JC, Pron G, Armstrong D (1992) Cranio-orbito-zygomatic measurements from standard CT scans in unoperated Crouzon and Apert infants: comparison with normal controls. Cleft Palate Craniofac J 29:129–136
Cho BC, Hwang SK, Uhm KI (2004) Distraction osteogenesis of the cranial vault for the treatment of craniofacial synostosis. J Craniofac Surg 15:135–144
Cohen MM Jr, Kreiborg S (1994) Cranial size and configuration in the Apert syndrome. J Craniofac Genet Dev Biol 14:153–162
Connolly JP, Gruss J, Seto ML, Whelan MF, Ellenbogen R, Weiss A, Buchman SR, Cunningham ML (2004) Progressive postnatal craniosynostosis and increased intracranial pressure. Plast Reconstr Surg 113:1313–1323
Cremin BJ, Zeeman BJ (1989) Three dimensional reconstruction in coronal synostosis: pre and post operative appearances. Pediatr Radiol 19:313–315
Cronqvist S (1968) Roentgenologic evaluation of cranial size in children. A new index. Acta Radiol Diagn 7:97–111
Crouzon O (1912) Dysostose cranio-faciale héréditaire. Bull Mem Soc Med Hop Paris 33:545–555
Cushing H (1908) Surgery of the head. In: Keen WW (ed) Surgery. Its principles and practice, vol 3. Saunders, Philadelphia, p 255
David DJ (2003) Advances in the management of the craniosynostoses. ANZ J Surg 73:949–957
David DJ, Abbott AH, Netherway DJ, Proudman TW (1996) Quantifying surgical intervention in Crouzon syndrome. In: Marchac D (ed) Craniofacial surgery. Proceedings of the Sixth International Congress of the International Society of Cranio-facial Surgery, Saint-Tropez (French Riviera), 1995. Montuzzi, Bologna, pp 187–190
Delashaw JB, Persing JA, Broaddus WC, Jane JA (1989) Cranial vault growth in craniosynostosis. J Neurosurg 70:159–165
Delashaw JB, Persing JA, Jane JA (1991) Cranial deformation in craniosynostosis. A new explanation. Neurosurg Clin N Am 2:611–620
Di Rocco C, Iannelli A, Velardi F (1980) Early diagnosis and surgical indication in craniosynostosis. Childs Brain 6:175–188
Di Rocco C, Marchese E, Velardi F (1992) Craniosynostosis: surgical treatment during the first year of life. J Neurosurg Sci 36:129–137
Dufresne CR, McCarthy JG, Cutting CB, Epstein FJ, Hoffman WY (1987) Volumetric quantification of intracranial and ventricular volume following cranial vault remodeling: a preliminary report. Plast Reconstr Surg 79:24–32
Farkas LG, Posnick JC (1992) Growth and development of regional units in the head and face based on anthropometric measurements. Cleft Palate Craniofac J 29:301–302
Farkas LG, Posnick JC, Hreczko TM (1992) Anthropometric growth study of the head. Cleft Palate Craniofac J 29:303–308
Fernandez F, Moule N, Singhi P, Singhi S (1984) Roentgenographic skull volume in Jamaican children between the ages of one month and five years. West Indian Med J 33:227–230
Fok H, Jones BM, Gault DG, Andar U, Hayward R (1992) Relationship between intracranial pressure and intracranial volume in craniosynostosis. Br J Plast Surg 45:394–397
Friede H, Lilja J, Lauritzen C, Anderson H, Johanson B (1986) Skull morphology after early craniotomy in patients with premature synostosis of the coronal suture. Cleft Palate J 23 [Suppl 1]:1–8
Gault DT, Renier D, Marchac D, Ackland FM, Jones BM (1990) Intracranial volume in children with craniosynostosis. J Craniofac Surg 1:1–3
Gault DT, Renier D, Marchac D, Jones BM (1992) Intracranial pressure and intracranial volume in children with craniosynostosis. Plast Reconstr Surg 90:377–381
Genitori L, Zanon N, Denis D, Erdincler P, Achouri M, Lena G, Choux M (1994) The skull base in plagiocephaly. Childs Nerv Syst 10:217–223
Gordon IR (1966) Measurement of cranial capacity in children. Br J Radiol 39:377–381
Gosain AK, McCarthy JG, Glatt P, Staffenberg D, Hoffmann RG (1995) A study of intracranial volume in Apert syndrome. Plast Reconstr Surg 95:284–295
Gratz KW, Locher MC, Carls FR, Haers PE, Sailer HF (1998) Cranial development after corrective skull surgery in craniosynostosis. Mund Kiefer Gesichtschir 2 [Suppl 1]:S49–S51
Guimaraes-Ferreira J, Gewalli F, David L, Olsson R, Friede H, Lauritzen CG (2003) Spring-mediated cranioplasty compared with the modified pi-plasty for sagittal synostosis. Scand J Plast Reconstr Surg Hand Surg 37:208–215
Hayward R, Harkness W, Kendall B, Jones B (1992) Magnetic resonance imaging in the assessment of craniosynostosis. Scand J Plast Reconstr Surg Hand Surg 26:293–299
Hayward R, Jones B, Gonsalez S, Hearst D (1996) Are the developmental problems seen in children with complex craniofacial syndromes preventable? In: Marchac D (ed) Craniofacial surgery. Proceedings of the Sixth International Congress of the International Society of Cranio-facial Surgery, Saint-Tropez (French Riviera), 1995. Montuzzi, Bologna, pp 171–173
Hearst D, Shipster C, Jones BM, Hayward RD (1996) Intellectual functioning, language and speech development in isolated sagittal synostosis. In: Marchac D (ed) Craniofacial surgery. Proceedings of the Sixth International Congress of the International Society of Cranio-facial Surgery, Saint-Tropez (French Riviera), 1995. Montuzzi, Bologna, pp 115–116
Henneberke M, Prahl-Andersen B (1994) Cranial base growth for Dutch boys and girls: a multilevel approach. Am J Orthod Dentofac Orthop 106:503–512
Hirabayashi S, Sugawara Y, Sakurai A, Tachi M, Harii K, Sato S (2002) Fronto-orbital advancement by distraction: the latest modification. Ann Plast Surg 49:447–450; discussion 450–451
Hockley AD, Wake MJ, Goldin H (1988) Surgical management of craniosynostosis. Br J Neurosurg 2:307–314
Hoffman HJ, Hendrick EB (1979) Early neurosurgical repair in craniofacial dysmorphism. J Neurosurg 51:796–803
Hoyte DA (1991) The cranial base in normal and abnormal skull growth. Neurosurg Clin N Am 2:515–537
Imai K, Komune H, Toda C, Nomachi T, Enoki E, Sakamoto H, Kitano S, Hatoko M, Fujimoto T (2002) Cranial remodelling to treat craniosynostosis by gradual distraction using a new device. J Neurosurg 96:654–659
Iqbal JB, Hockley AD, Wake MJC, Goldin JH (1994) Transcranial Doppler sonography in craniosynostosis. Childs Nerv Syst 10:259–263
Jaffe M, Tal Y, Hadad B, Tirosh E, Tamir A (1992) Variability in head circumference growth rate during the first 2 years of life. Pediatrics 90:190–192
Jimenez DF, Barone CM, Cartwright CC, Baker L (2002) Early management of craniosynostosis using endoscopic-assisted strip craniectomies and cranial orthotic molding therapy. Pediatrics 110:97–104
Jones BM, Jani P, Bingham RM, Mackersie AM, Hayward R (1992) Complications in paediatric craniofacial surgery: an initial four year experience. Br J Plast Surg 45:225–231
Khan SH, Nischal KK, Dean F, Hayward RD, Walker J (2003) Visual outcomes and amblyogenic risk factors in craniosynostotic syndromes: a review of 141 cases. Br J Ophthalmol 87:999–1003
Kolar JC, Salyer KE, Yamada A (2001) Assessment of postoperative cranial vault growth in syndromal synostosis. In: Lauritzen CK (ed) Craniofacial surgery. Proceedings of the Ninth International Congress of the International Society of Craniofacial Surgery, Visby, Gotland (Sweden). Monduzzi, Bologna, pp 41–43
Kreiborg S, Cohen MM Jr (1991) The infant Apert skull. Neurosurg Clin N Am 2:551–554
Kreiborg S, Marsh JL, Cohen MM Jr, Liversage M, Pedersen H, Skovby F, Borgesen SE, Vannier MW (1993) Comparative three-dimensional analysis of CT-scans of the calvaria and cranial base in Apert and Crouzon syndromes. J Craniomaxillofac Surg 21:181–188
Lannelogue M (1890) De la craniectomie dans la microcephalie. C R Acad Sci Paris 110:1382–1385
Lavelle CL (1985) Craniofacial growth in patients with craniosynostosis. Acta Anat 123:201–206
Lauritzen C, Tarnow P (2003) Craniofacial surgery over 30 years in Goteborg. Scand J Surg 92:274–280
Lauritzen C, Guimaraes-Fereira J, Gewalli F, Olsson R, David L, Tarnow P (2001) Three years experience with implantable springs in craniofacial surgery. In: Lauritzen CK (ed) Craniofacial surgery. Proceedings of the Ninth International Congress of the International Society of Craniofacial surgery, Visby, Gotland (Sweden). Monduzzi, Bologna, pp 165–168
Leboucq N, Montoya P, Martinez Y, Castan P (1991) Value of 3D imaging for the study of craniofacial malformations in children. J Neuroradiol 18:225–239
Liasis A, Thompson DA, Hayward R, Nischal KK (2003) Sustained raised intracranial pressure implicated only by pattern reversal visual evoked potentials after cranial vault expansion surgery. Pediatr Neurosurg 39:75–80
Lichtenberg RJG (1960) Radiographie du crane de 226 enfants normaux de la naissance a 8 ans. Impressions digitiformes, capacité, angles et indices. These, Faculté de Médecine de Paris
Lyn Chong S, Mitchell R, Moursi AM, Winnard P, Losken HW, Bradley J, Ozerdem OR, Azari K, Acarturk O, Opperman LA, Siege MI, Mooney MP (2003) Rescue of coronal suture fusion using transforming growth factor-beta 3 (TGF-beta 3) in rabbits with delayed-onset craniosynostosis. Anat Rec 274A:962–971
MacKinnon IL, Kennedy JA, Davies TV (1956) The estimation of skull capacity from roentgenologic measurements. Am J Roentgenol Radium Ther Nucl Med 76:303–310
Magnano M, Albera R, Lacilla M, Gabini A, Naddeo M, Bruno D (1994) Impedance measurement as a noninvasive technique for the monitoring of intracranial pressure variations. Audiology 33:237–243
Marchac D (1978) Radical forehead remodelling for craniostenosis. Plast Reconstr Surg 61:823–835
Marchac D, Renier D (1987) Treatment of craniosynostosis in infancy. Clin Plast Surg 14:61–72
Marchac D, Renier D (1996) Faciocraniosynostosis from infancy to adulthood. Childs Nerv Syst 12:669–677
Marchac D, Renier D, Jones BM (1988) Experience with the floating forehead. Br J Plast Surg 41:1–15
Marchac D, Renier D, Broumand S (1994) Timing of treatment for craniosynostosis and faciocraniosynostosis: a 20-year experience. Br J Plast Surg 47:211–222
Marsh JL, Vannier MW (1986) Cranial base changes following surgical treatment of craniosysnostosis. Cleft Palate J 23 [Suppl 1]:9–18
Marsh JL, Vannier MW (1987) The anatomy of the cranio-orbital deformities of craniosynostosis: insights from 3-D images of CT scans. Clin Plast Surg 14:49–60
Marsh JL, Galic M, Vannier MW (1991) The craniofacial anatomy of Apert syndrome. Clin Plast Surg 18:237–249
Matsunoto K, Nakanishi H, Kubo Y, Yokozeki M, Mpriyama K (2003) Advances in distraction techniques for craniofacial surgery. J Med Invest 50:117–125
McCarthy JG, Epstein F, Sadove M, Grayson B, Zide B (1984) Early surgery for craniofacial synostosis: an 8-year experience. Plast Reconstr Surg 73:521–533
Menichini G, Ruiu A (1960) Sulla valutazione radiologica della capacità cranica nel lattante. Minerva Pediatr 12:1358
Moone MP, Moursi AM, Opperman LA, Siegel MI (2004) Cytokine therapy for craniosynostosis. Expert Opin Biol Ther 4:279–299
Moore MH, Abbott AH (1996) Extradural dead space after infant fronto-orbital advancement in Apert syndrome. Cleft Palate Craniofac J 33:202–205
Moore MH, Hanieh A (1996) Cerebrospinal fluid spaces before and after infant fronto-orbital advancement in unilateral coronal craniosynostosis. J Cranfac Surg 7:102–106
Moss ML (1959) The pathogenesis of premature cranial synostosis in man. Acta Anat 37:351–370
Moss ML (1975) Functional anatomy of cranial synostosis. Childs Brain 1:22–33
Mühlbauer W, Anderl H, Heeckt P, Ramatschi P, Vertesy E (1985) Early facial advancement in craniofacial stenosis. In: Marchac D (ed) Craniofacial surgery. Proceedings of the First International Congress of the International Society of Cranio-maxillo-facial Surgery, Cannes–La Napoule. Springer, Berlin Heidelberg New York, pp 123–129
Nellhaus G (1968) Head circumference from birth to eighteen years. Practical composite international and interracial graphs. Pediatrics 41:106–114
Ohman JC, Richtsmeier JT (1994) Perspectives on craniofacial growth. Clin Plast Surg 21:489–499
Otto AW (1830) Lehrbuch der Pathologischen Anatomie. Rücher, Berlin
Persing JA, Jane JA, Shaffrey M (1989) Virchow and the pathogenesis of craniosynostosis: a translation of his original work. Plast Reconstr Surg 83:738–742
Posnick JC, Lin KY, Chen P, Armstrong D (1993) Sagittal synostosis: quantitative assessment of presenting deformity and surgical results based on CT scans. Plast Reconstr Surg 92:1015–1024
Posnick JC, Lin KY, Jhawar BJ, Armstrong D (1993) Crouzon syndrome: quantitative assessment of presenting deformity and surgical results based on CT scans. Plast Reconstr Surg 92:1027–1037
Posnick JC, Lin KY, Jhawar BJ, Armstrong D (1994) Apert syndrome: quantitative assessment by CT scan of presenting deformity and surgical results after first-stage reconstruction. Plast Reconstr Surg 93:489–497
Posnick JC, Armstrong D, Bite U (1995) Crouzon and Apert syndromes: intracranial volume measurements before and after cranio-orbital reshaping in childhood. Plast Reconstr Surg 96:539–548
Posnick JC, Armstrong D, Bite U (1995) Metopic and sagittal synostosis: intracranial volume measurements before and after cranio-orbital reshaping in childhood. Plast Reconstr Surg 96:299–309
Reinhart E, Muhling J, Michel C, Collman H, Pistner H, Reuther J (1996) Craniofacial growth characteristics after bilateral fronto-orbital advancement in children with premature craniosynostosis. Childs Nerv Syst 12:690–694
Relethford JH (1994) Craniometric variation among modern human populations. Am J Phys Anthropol 95:53–62
Renier D, Sainte-Rose C, Marchac D, Hirsch JF (1982) Intracranial pressure in craniostenosis. J Neurosurg 57:370–377
Renier D, Brunet L, Marchac D (1987) I.Q. and craniostenosis. Evolution in treated and untreated cases. In: Marchac D (ed) Craniofacial surgery. Proceedings of the First International Congress of the International Society of Cranio-maxillo-facial Surgery, Cannes–La Napoule, 1985. Springer, Berlin Heidelberg New York, pp 114–117
Renier D, Arnaud E, Cinalli G, Sebag G, Zerah M, Marchac D (1996) Prognosis for mental function in Apert’s syndrome. J Neurosurg 85:66–72
Rich PM, Cox TC, Hayward RD (2003) The jugular foramen in complex and syndromic craniosynostosis and its relationship to raised intracranial pressure. Am J Neuroradiol 24:45–51
Richtsmeier JT (1988) Craniofacial growth in Apert syndrome as measured by finite-element scaling analysis. Acta Anat 133:50–56
Salyer K, Corcoran J, Hubli E, Colyer J (1996) Sequence of surgical intervention in syndromal synostosis. In: Marchac D (ed) Craniofacial surgery. Proceedings of the Sixth International Congress of the International Society of Cranio-facial Surgery, Saint-Tropez (French Riviera), 1995. Montuzzi, Bologna, pp 183–185
Salyer KE, Kolar JC, Yamada A, Genecov DG, Bruce DA, Shapiro K (2001) Intracranial remodelling for syndromal craniosynostosis: 12 year experience. In: Lauritzen CK (ed) Craniofacial surgery. Proceedings of the Ninth International Congress of the International Society of Craniofacial Surgery, Visby, Gotland (Sweden). Monduzzi, Bologna, pp 51–54
Scheuerle J, Habal MB (1992) Behavior assessment before and after corrective surgery. In: Montoya AG (ed) Craniofacial surgery. Proceedings of the Fourth Meeting of the International Society of Cranio-maxillo-facial Surgery, Santiago de Compostela (Spain), 1991. Monduzzi, Bologna, pp 31–32
Sgouros S, Goldin JH, Hockley AD, Wake MJC (1996) Surgery for unilateral coronal synostosis (plagiocephaly)—unilateral or bilateral correction? J Craniofac Surg 7:284–289
Sgouros S, Goldin JH, Hockley AD, Wake MJC (1996) Posterior skull surgery in craniosynostosis. Childs Nerv Syst 12:727–733
Sgouros S, Goldin JH, Hockley AD, Wake MJC (1996) Birmingham craniofacial score. A scoring system for craniofacial deformities. J Craniofac Surg 7:336–340
Sgouros S, Goldin JH, Hockley AD, Wake MJC, Natarajan K (1999) Intracranial volume change in childhood. J Neurosurg 91:610–616
Sgouros S, Goldin JH, Hockley AD, Wake MJC, Natarajan K (1999) Intracranial volume change in craniosynostosis. J Neurosurg 91:617–625
Slomic AM, Bernier JP, Morissette J, Renier D (1992) A craniometric study of sagittal craniosynostosis (SC). J Craniofac Genet Dev Biol 12:49–54
Slomic AM, Bernier JP, Morissette J, Renier D (1992) A craniometric study of bicoronal craniosynostosis (BCC). J Craniofac Genet Dev Biol 12:174–181
Stavrou P, Sgouros S, Willshaw HE, Goldin JH, Hockley AD, Wake MJC (1997) Visual failure due to raised intracranial pressure in craniosynostosis. Childs Nerv Syst 13:64–67
Tessier P (1967) Ostéotomies totales de la face; syndrome de Crouzon; syndrome d’Apert; oxycéphalies, scaphocéphalies, turricéphalies. Ann Chir Plast 12:273–286
Tessier P (1971) The definitive plastic surgical treatment of the severe facial deformities of craniofacial dysostosis. Crouzon’s and Apert’s disease. Plast Reconstr Surg 48:612–618
Thompson DNP, Harkness W, Jones B, Gonsalez S, Andar U, Hayward R (1995) Subdural intracranial pressure monitoring in craniosynostosis: its role in surgical management. Childs Nerv Syst 11:269–275
Thompson DNP, Malcolm GP, Jones BM, Harkness WJ, Hayward RD (1995) Intracranial pressure in single-suture craniosynostosis. Pediatr Neurosurg 22:235–240
Thompson DNP, Jones B, Harkness W, Gonsalez S, Hayward R (1997) Consequences of cranial vault expansion surgery for craniosynostosis. Pediatr Neurosurg 26:296–303
Tuite GF, Evanson J, Chong WK, Thompson DNP, Harkness WF, Jones BM, Hayward RD (1996) The beaten copper cranium: a correlation between intracranial pressure, cranial radiographs, and computed tomographic scans in children with craniosynostosis. Neurosurgery 39:691–699
Tuite GF, Chong WK, Evanson J, Narita A, Taylor D, Harkness WF, Jones BM, Hayward RD (1996) The effectiveness of papilledema as an indicator of raised intracranial pressure in children with craniosynostosis. Neurosurgery 38:272–278
Uemura T, Hayashi T, Satoh K, Mitsukawa N, Yoshikawa A, Suse T, Furukawa Y (2003) Three-dimensional cranial expansion using distraction osteogenesis for oxycephaly. J Craniofac Surg 14:29–36
Vander Kolk CA, Beaty T (1994) Etiopathogenesis of craniofacial anomalies. Clin Plast Surg 21:481–488
Vannier MW, Hildebolt CF, Marsh JL, Pilgram TK, McAlister WH, Shackelford GD, Offutt CJ, Knapp RH (1989) Craniosynostosis: diagnostic value of three-dimensional CT reconstruction. Radiology 173:669–673
Virchow R (1851) Über den Cretinismus, namentlich in Franken, und über pathologische Schädelformen. Verh Phys Med Ges Würzbg 2:230–271
Waitzman AA, Posnick JC, Armstrong DC, Pron GE (1992) Craniofacial skeletal measurements based on computed tomography. II. Normal values and growth trends. Cleft Palate Craniofac J 29:118–128
Wall SA, Goldin JH, Hockley AD, Wake MJ, Poole MD, Briggs M (1994) Fronto-orbital re-operation in craniosynostosis. Br J Plast Surg 47:180–184
Whitaker LA, Bartlett SP, Schut L, Bruce D (1987) Craniosynostosis: an analysis of the timing, treatment, and complications in 164 consecutive patients. Plast Reconstr Surg 80:195–212
Whittle IR, Johnston IH, Besser M (1984) Intracranial pressure changes in craniostenosis. Surg Neurol 21:367–372
Yonehara Y, Hirabayashi S, Sugawara Y, Sakurai A, Harii K (2003) Complications associated with gradual cranial vault distraction osteogenesis for the treatment of craniofacial synostosis. J Craniofac Surg 14:526–528
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Sgouros, S. Skull vault growth in craniosynostosis. Childs Nerv Syst 21, 861–870 (2005). https://doi.org/10.1007/s00381-004-1112-2
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DOI: https://doi.org/10.1007/s00381-004-1112-2