Sagittal synostosis after excision of congenital pigmented nevus of the scalp: a possible complication of the tissue expansion technique

• Published in: European journal of plastic surgery 2015-12, Vol.38 (6), p.491-494
• Main Authors: Keiko, Takada, Ikkei, Tamada
• Format: Article
• Language: English
• Subjects: Case Report; Medicine; Medicine & Public Health; Plastic Surgery
• ISSN: 0930-343X; 1435-0130
• DOI: 10.1007/s00238-015-1099-9

We report a case of sagittal synostosis that was detected because of cranial deformity 5 years after a congenital pigmented nevus of the scalp was resected using the tissue expansion (TE) technique. Currently, no case report describes the association between TE and craniosynostosis. To explain the mechanism of the craniosynostosis in the present case, we considered that the area of placement, number of expanders, injection schedule, age at operation, or a combination of these may have been responsible for early suture fusion. Considering that complete fusion of the sagittal suture was observed on the postoperative computed tomography but that the compensatory change of the cranial shape was relatively minor, we speculated that the changes in the patient’s skull could have been secondary (late-onset) sagittal synostosis caused by the surgery. Because the deformity in secondary craniosynostosis is relatively minor, it may be overlooked by some surgeons. We recommend careful placement of the expander and long-term follow-up, especially in infants. Level of Evidence: Level V, risk/prognostic study.