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Transsutural distraction osteogenesis for 285 children with craniosynostosis: a single-institution experience
Open accessAbstract
OBJECT: Although distraction osteogenesis (DO) requires a secondary procedure in the surgical correction of craniosynostosis, it is relatively simple, requires less transfusion, results in a shorter intensive care unit stay, and is quite safe. Because of these positive factors, various DO techniques have been developed. However, there is disagreement regarding the superiority of DO. The authors reported on a new DO technique, transsutural DO (TSDO), 6 years ago that was performed in 23 patients over a period of 6 months, and it continues to be used at the present time. In this paper the authors report the results of TSDO performed in 285 patients with craniosynostosis over a period of 6 years at a single institution. METHODS: TSDO consists of a simple suturectomy of the pathological suture followed by direct distraction of the suturectomy site only. Types of TSDO conducted included sagittal TSDO in 95 patients, bicoronal in 14, unilateral coronal in 57, lambdoid in 26, metopic in 13, multiple in 19, syndromic in 33, and secondary in 28. The mean age (± SD) of the patients was 19.4 ± 23.0 months, and mean follow-up was 39.5 ± 21.0 months. RESULTS: The mean operating time was 115 ± 43 minutes, and mean anesthesia time was 218 ± 56 minutes. The mean transfusion volume of red blood cell components was 48 ± 58 ml, and mean transfusion volume of fresh-frozen plasma was 19 ± 35 ml. Total transfusion volume was significantly less in infants younger than 12 months of age and in children with lower lumbar puncture pressures (p < 0.05). Complications included 1 (0.4%) death from postoperative acute pneumonia after a distractor removal operation and 23 (8%) surgical morbidities comprising 10 revisions (3.5%) and 13 early removals of distracters (4.6%). CONCLUSIONS: TSDO is a simple, effective, and safe method to use for treating all types of craniosynostosis. Some morbidity was experienced in this study, but it may be attributed to the learning curve of the technique.
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Alternative surgical techniques such as the Peau d'Ours technique, triple square extended osteotomies, and transsutural distraction osteogenesis remain limited to specialized centres and lack widespread clinical acceptance due to their complexity and the availability of more established techniques.
“Despite ongoing advancements, several alternative surgical techniques remain limited to specialized centres. Approaches such as the Peau d'Ours technique, triple square extended osteotomies, and transsutural distraction osteogenesis have been explored but lack widespread clinical acceptance due to their complexity and the availability of more established techniques [54, 81–84].”
From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [84]
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Metadata
- Authors
- Park, D. H., & Yoon, S. H.
- Affiliations
- Departments of Plastic and Reconstructive Surgery, and
- Ajou University (KR)
- Venue
- Journal of Neurosurgery: Pediatrics
- Published
- 2016-02
- Volume
- 17
- Issue
- 2
- Pages
- 230-239
- ISSN
- 1933-0707 (ISSN-L)
- 1933-0715
- OpenAlex
- W2145892445
- Cited by
- 20
- References
- 31
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 3 · 2016: 4
- FWCI
- 1.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurosurgery Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- AJOU Open Repository (Ajou University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Craniofacial Disorders and Treatments
- Health Sciences › Medicine › Surgery › Pectus Deformity Diagnosis and Treatment
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone fractures and treatments
- Keywords
- craniosynostosis, suturectomy, syndromic craniosynostosis, surgical complications, blood transfusion, postoperative pneumonia, learning curve, pediatric neurosurgery
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