Sharma, JD;
O'Hara, JL;
Borghi, A;
Rodriguez-Florez, N;
Breakey, W;
Ong, J;
Jeelani, NO;
... James, G; + view all
(2018)
Results Following Adoption of a Modified Melbourne Technique of Total Scaphocephaly Correction.
Journal of Craniofacial Surgery
, 29
(5)
pp. 1117-1122.
10.1097/SCS.0000000000004593.
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Abstract
The Melbourne technique was described in 2008 as a novel method for complete correction of scaphocephaly. Since 2015, it has become our operation of choice for children with sagittal synostosis who are too old at presentation for minimally invasive techniques. Our modifications were 2-position (initially supine then prone) technique and undertaking a formal fronto-orbital remodeling to correct forehead contour. Retrospective chart review was used to record demographics, blood transfusion frequency and volumes, operating time, length of stay, clinical outcome, and complications. Eleven underwent modified Melbourne procedure between July 2015 and March 2017; 9 of 11 were male. All had a diagnosis of nonsyndromic sagittal synostosis. Mean age at surgery was 29 months. Mean surgical time was 6 hours. All patients required blood transfusion with a mean volume transfused of 29 mL/kg (range 13–83 mL/kg). For those 5 patients where preoperative and postoperative measurements were available, there was an increase in mean cephalic index (CI) from 0.64 to 0.75. All postoperative patients had a CI of over 0.70. Three-dimensional shape analysis indicated head shape change addressing all phenotypic aspects of scaphocephaly. In the 5 patients in which analysis could be undertaken, the mean intracranial volume increased from 1481 cm^{3} preoperatively to 1671 cm^{3} postoperatively, a mean increase in intracranial volume of 14%. The postoperative intracranial volume was higher than preoperative in all 5 patients. There were 4 minor and no major complications. Modified Melbourne procedure is safe and effective for the treatment of severe scaphocephaly in sagittal synostosis.
| Type: | Article |
|---|---|
| Title: | Results Following Adoption of a Modified Melbourne Technique of Total Scaphocephaly Correction |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/SCS.0000000000004593 |
| Publisher version: | https://doi.org/10.1097/SCS.0000000000004593 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. |
| Keywords: | scaphocephaly, craniosynostosis, sagittal synostosis |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10112008 |
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