Pediatric Skull Augmentation
Q: Dr. Eppley, I am interested in pediatric skull augmentation. I have a 2 year old son with untreated brachcephaly and plagiocephaly (assymetric brachcephaly). What are the possible side effects of bone cement or a custom implant? Have you done skull reshaping on any children? If so, how many? What age would be ideal for this surgery and how will the cement or implant adjust/effect him as he grows? Finally what is an estimated general cost of this procedure and what is the recovery time? Also I would be extremely concerned about anesthesia for him at a young age. Would you bring in a pediatric anesthesiologist? Thank you for your time.
A: I have done numerous cases of pediatric skull augmentation (onlay cranioplasties) for occipital skull deformations. The use of hydroxyapatite bone cements seems the most appropriate at this young age since the bone will grow into and around it and it will grow proportionately with the surrounding skull bone. I see no reason to perform his skull augmentation surgery until 4 or 5 years of age when the child is older and the skull is more fully formed. This surgery should be done in a pediatric facility (Children’s Hospital) under the management of a pediatric anesthesiologist. Because of the expenses involved this should be a procedure that is done through insurance which requires a predetermination process for approval.
Dr. Barry Eppley