Diagnosed with a rare condition called Bicoronal
Craniosynostosis after birth, where the skull fuses too early, Peter Smith's daughter, Beth, has had several life-saving operations at Birmingham Children's Hospital to reduce the pressure on her brain.
The patient underwent the anterior craniofacial resection with placement of a galeal-pericranial flap; the neurosurgery service performed a bicoronal
bifrontal craniotomy repair of the dura.
The incision may be bicoronal
or in horseshoe bifrontoparietal centered in the coronal suture unilaterally or bilaterally.
After non-sterile registration of the entry location, routine surgical preparation and drape were performed, followed by a bicoronal
Craniofacial resection via combined bicoronal
and Weber-Ferguson approaches was performed for definitive resection with good result.
reported 12 Percent rate of wound infection with a bicoronal
flap while Kerawala et al.
Las perdidas sanguineas varian segun el tipo de correccion (sutura sagital, perdida del 25%; unicoronal, del 21%; bicoronal
, del 65%; metopica, del 42%) y la tecnica quirurgica usada.
Forehead of the patient was exposed with a bicoronal
incision and anterior sub periosteal flap was raised.
She was taken to the operating the following morning for a bicoronal
craniotomy for a gross-total tumor resection with neuronavigation (Fig 2).
En una segunda intervencion se realizo incision bicoronal
, disecando colgajo cutaneo de duramadre, se levanto el colgajo y se diseco duramadre de la tabla interna, realizando craneotomia en bandas de aproximadamente 4 cm de la porcion superior hacia la base, posteriormente remodelando el colgajo, se realizo craneoplastia colocando los mismos fragmentos del hueso y dren.
Some patients had multiple suture involvement including the following suture combinations: right coronal/metopic, left lambdoid/sagittal/left coronal, sagittal/metopic, right coronal/ sagittal/metopic, bicoronal
/sagittal, and bilateral lambdoid/sagittal; and three patients had bicoronal
Among the open approaches, the placement of an osteoplastic flap through a bicoronal
incision appears to be associated with the least morbidity.