Health

Baby gets 1mm skull stretch every day


Doctor Dang Hoang Thom (Head of the Department of Craniofacial and Plastic Surgery, National Children’s Hospital), said that all of the children’s skull joints were healed prematurely, the closed skull could not expand, making the space in the box The skull is not enough, not suitable to respond to the development of the brain, causing increased intracranial pressure. The frontal bone mass complex – orbital ceiling of the base of the skull and the middle layer of the face is hypoplastic, making the baby’s eyes grow bigger and bigger, can’t close properly, causing discomfort, dry corneal ulcers, lacrimation, vision loss and can lead to blindness. The skull is completely deformed, the head is long and flattened, rising like a pyramid, children often have sleep apnea.

Doctors determined this was a difficult and complicated case, requiring plastic surgery to expand the skull volume to match the brain volume as well as the future brain development and reconstruct the box shape. skull. The plastic surgery plan for pediatric patients is built in 2 different stages, suitable for brain development as well as facial aesthetics. In particular, the skull expansion stage needs to be performed early because the child has severe clinical signs such as increased intracranial pressure, thin bones, bone erosion, headache, nausea, fatigue.. If not early intervention will affect the function and leave many sequelae for children.

“We used the technique of stretching the posterior cranial vault with a stretcher, helping to increase the volume of the child’s skull by 30% compared to the original. With this technique, the child’s skull will be expanded slowly. 1mm/day, divided into 2 times in the morning and afternoon, through stretching with specialized equipment.Every day, the child will have the skull stretched, monitored and evaluated until the skull volume is reached. desired,” said Dr. Thom.

About 5 days after surgery, the volume of the baby’s skull begins to increase. Children completely reduced nausea, after 10 days, vomiting completely stopped, eyes were able to close, eat well, sleep deeply, signs of wheezing completely. The baby’s head has changed markedly, before it was flat, the top of the head was high and pointed, now it’s back to normal.

Dr. Thom is examining and assessing the condition of the patient after the treatment. Photo: Khanh Chi

According to Dr. Thom, congenital craniosynostosis (Croniosynostosis) is an early healing disease of one or more skull joints. The case of this baby is early healing of all skull joints, small, flattened, pyramidal Oxycephaly.

Cranial stenosis causes early craniosynostosis, making it impossible for the skull to expand, while the baby’s brain develops day by day, especially in the first 1.5 years of life. The skull cannot expand, causing an imbalance between the volume of the skull and the volume of the brain, leading to increased intracranial pressure, thinning of the skull bones, and even brain organization due to insufficient space. grow close to the skull plate, perforating the skull bone, creating finger prints on the skull plate.

In the past, with cases like this baby, it would be necessary to surgically remove all the skull plates and then reassemble. At that time, pediatric patients are at increased risk of meningeal damage, poor nutrition of the skull plate, the possibility of infection, bone loss, displacement and deformation of the skull, complicated postoperative resuscitation… Now, Doctors have applied the technique of stretching the posterior cranial vault with the KLS Martin dilator in the treatment of congenital craniocervical stenosis. This is a less invasive method of intervention, without taking the skull plate out, keeping the shape of the skull arch, the skull plate is not separated from the skull, helping the skull plate to be well nourished, over time. The surgery is shorter, the risk of bleeding is reduced, and the post-operative resuscitation care is also faster.

“Especially to create a gradual, continuous and natural adaptation between the skull to be shaped and the brain organization until the desired skull volume is obtained in accordance with the treatment plan, not suddenly create a large space like old surgical methods,” explained Dr. Thom.

In the past two years, the Department of Craniofacial and Plastic Surgery combined with the Department of Diagnostic Imaging, Department of Anesthesiology and Cardiovascular Resuscitation – Cardiology Center and Department of Intensive Care Surgery successfully operated and treated nearly 20 patients. Pediatric patients with congenital craniocervical stenosis by means of dilating the posterior cranial vault with a stretcher. The successful application of this new technique has opened up a lot of hope for unfortunate babies with congenital craniocervical stenosis.

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