Craniosynostosis surgery - Dr. Ehtesham Ul Haq

The incidence of craniosynostosis is around 1 : 2500 live births and can range from single suture to multiple suture fusion. This can lead to typical patterns of deformity. More than one suture involvement can lead to more severe deformity and more adverse effects on brain growth. The synostosis if not corrected at proper time can lead to progressive deformation of not only the skull but also of the face in general and orbits and nose in particular. Mental retardation, diminished vision and hearing and abnormal balance are some of the features of uncorrected synostosis. This can have devastating effects on the growing child and the parents. Corrective surgery is recommended around 06 months to 01 year of age. The team involves a pediatric anesthetist ,Craniofacial surgeon and a Neurosurgeon with expertise in pediatric neurosurgery.

The First ever case of Forehead remodeling and advancement was done in a 06 month old baby girl at CMH Rawalpindi in June 2009. My dear friend and Medical school class fellow Dr. Atif Kazmi(Neurosurgeon) of high repute ,sharing a passion for craniofacial surgery with me ,and myself undertook this earth breaking and huge task and completed the procedure in 08 hours. This collaborative work has been going on since then. We have operated not only on all the varieties of craniosynostosis but also cases of Orbital hypertelorism and skull base tumors and post traumatic skull and facial defects.

Unlocking The Growth Potential.

The philosophy and concept of Skull remodeling takes its root in the fact that cranium being a guard for the underlying brain grows and expands providing room for growth of the brain. The skull bones unite with each other at the sites of the sutures. When the bones fuse prematurely the result is a predictable alteration in growth pattern resulting in a progressive and variable deformity.

**Sutures and Fontanelles in a new born.**

The brain if normal in architecture becomes imprisoned in this new altered environment. Cranial vault remodeling aims at bringing the forehead and vault into a normal shape ,thus unlocking the “growth potential”. The advancement done during surgery releases the brain and sets it free to grow to its fullest potential. The baby is thus not only relieved from developing a ongoing cranial and facial deformity but is also set on the path to a normal personality development and growth, hence the adverse effects of long term constriction on the brain are averted. https://rb.gy/gfm05w