Clinical Evaluation of Nonsyndromic Scaphocephaly Surgically Corrected by Floating Bilateral Parietal Bone Flaps Technique Between 2001 and 2021, A Retrospective Study

Abstract

BACKGROUND: Scaphocephaly is a common cranial deformity characterized by a long, narrow head, frontal bossing, and a sharp, prominent occiput. These features can affect brain integrity and potentially lead to neurological impairment. Various techniques for correcting sagittal synostosis have been described, each with its own advantages and challenges. This study aimed to evaluate the efficacy of floating bilateral parietal bone flaps in improving head shape in patients with scaphocephaly. METHODS: This study examined patients with nonsyndromic sagittal synostosis who underwent surgery using the floating biparietal bone flap technique between 2001 and 2021. The patients, aged 6 months to 9 years, received biparietal floating bone flaps without frontal or occipital surgical intervention. Postoperative outcomes were evaluated by 2 consultant plastic surgeons, using preoperative and postoperative clinical photographs and documenting any surgical complications. RESULTS: The study included 30 cases, with ages ranging from 6 to 118 months, and a mean age of 24.7 months. The mean intraoperative blood loss was 90.0+/-31.7 mL, and the average operation time was 246 minutes. The patients were classified with a mean Whitaker score of 1.27+/-0.48 by 2 experts, with no complications reported. All patients achieved satisfactory postoperative outcomes in terms of head shape. CONCLUSIONS: This study demonstrated the functional and aesthetic benefits of using floating parietal bone flaps in scaphocephaly surgery. This simplified technique resulted in minimal calvarial and dural manipulation, reduced intraoperative blood loss and transfusion requirements, shorter operation time, and a decreased length of hospital stay. In addition, no hardware fixation was used.