Cranial Vault Expansion

Article Teaser

Neurosurgeons in Le Bonheur’s Craniofacial Program perform cranial vault expansion to correct and reduce the risk of future craniofacial deformities caused by pediatric craniosynostosis (craniostenosis).

What is cranial vault expansion?
Cranial vault expansion is a surgery to correct and reduce the risk of future craniofacial deformities caused by a condition called pediatric craniostenosis. Pediatric craniosynstenosis is the name of a condition where pediatric sutures, which are bony plates in an infant's head, fuse together too early. When this happens the skull can't stretch and expand as a child's brain grows.

What are the benefits of cranial vault expansion?
Cranial vault expansion is the only treatment for pediatric craniostenosis.
Cranial vault expansion can:

  • Return a baby's skull to its normal shape
  • Relieve pressure on the brain
  • Prevent developmental delays and permanent disabilities.

The multi-disciplinary craniofacial team at Le Bonheur Children's Medical Center can perform an extensive evaluation to determine whether your child can benefit from cranial vault expansion.

At what age should cranial vault expansion be performed?
Usually, surgery is performed as soon as craniostenosis is diagnosed. The sooner surgery is performed, the less risk there is for ongoing problems such as developmental delays and permanent brain damage.

What happens during a cranial vault expansion procedure?
While your child is under general anesthesia (fully asleep), a pediatric neurosurgeon will remove strips of bone in the skull to create artificial pediatric sutures. This relieves pressure on the brain and allows the skull to expand normally.

A craniofacial plastic surgeon then reshapes the skull bones. Special plates and screws are used to hold the shape while the bones heal. These plates and screws dissolve in one or two years.

Only one incision is needed for cranial vault expansion. This incision is made in a zigzag line from just above one ear to just above the other.  The scar is usually covered completely by hair within months of the surgery.

After cranial vault expansion, you child will be cared for in the intensive care unit (ICU) for one night and then will be monitor0ed in the neuroscience unit for three to four more days.

What is endoscopic cranial vault expansion?
Endoscopic cranial vault expansion is a less invasive approach to treating pediatric craniostenosis. The closed pediatric suture is removed through one or two small incisions. Screws are not required to hold the bones in place. This decreases the risk of infection, swelling and allergic reaction.  The surgery is shorter and recovery is quicker.

Endoscopic cranial vault expansion may be an option for babies who are five months of age and younger.

Children who have endoscopic cranial vault expansion will need to wear a helmet for about a year to help guide the growth of the brain.

Why Le Bonheur?
The craniofacial team at Le Bonheur Children's Medical Center includes some of the most respected pediatric neurosurgeons and craniofacial surgeons in the United States. The hospital's Craniofacial Program is a key component of the hospital's Neuroscience Institute, a center of excellence dedicated to the evaluation and treatment of neurological disorders in children and adolescents. Children from across the country visit Le Bonheur each year to be treated at the Institute.