Craniofacial distraction for syndromic craniosynostoses: evidence of an operative learning curve Distração craniofacial para tratamento das craniossinostoses: evidência de uma curva de aprendizagem operatória

Purpose: A critical evaluation of the use of distraction osteogenesis in the surgical treatment of syndromic craniosynostoses, based on the experience of a single institution, with an emphasis on surgical pitfalls and complications. Methods: Retrospective review of the clinical data of eleven patients operated on in the same institution. Medical charts, surgical notes and other relevant data were analyzed and the patients’ symptoms and signs, diagnosis, surgical treatment details and complications were assembled. results: All patients underwent craniofacial distraction with rigid distractors. Ten of them underwent monobloc frontofacial advancement. In one patient a LeFort III advancement was performed. All patients had exorbitism and signs of intracranial hypertension preoperatively, whilst eight (73%) had upper airway obstruction. Craniofacial distraction surgery promoted an improvement in all patients. Cerebrospinal fluid leakage was the most frequent complication in this series, occurring in 5 cases (45%). conclusions: The evolution of surgical techniques allowed distraction osteogenesis with rigid distractors to be an important tool for treating the craniofacial issues related to syndromic craniosynostoses.