Cooper's Fused Skull Springs Back Into Shape

Sydney Morning Herald

Saturday November 15, 2008

Kate Benson Medical Reporter

COOPER Packham was only hours old when nurses noticed his head was an odd shape.

"It looked like a little football with a ridge running down the middle," his mother, Lisa Hardman, said yesterday. But staff at Armidale hospital, where he was born, assured her it would regain a more natural shape within days.

Three weeks later Cooper's head was even more elongated, and he was diagnosed with sagittal craniosynostosis, a condition affecting about one in 3000 babies, in whom two sides of the skull are prematurely fused.

At nine weeks old he became one of the first babies in Australia to undergo a radical procedure to separate the plates.

Babies are born with flexible skull bones to allow their brains to grow and their heads to fit more easily through the birth canal, but if the plates are fused the skull is forced to grow vertically, eventually causing brain damage.

In Australia, nine babies with craniosynostosis have had springs inserted in their skulls since the procedure, developed in Sweden, was introduced at Sydney Children's Hospital this year.

During surgery, two springs are inserted where the bones are fused to gradually reshape the skull. The technique is less invasive than complex cranial vault remodelling and causes less blood loss.

But it is still controversial, some experts believing it has not yet shown long-term success.

The head of Craniofacial Australia, Professor David David said: "There have been some good results and not so good results, and it requires a second operation three months later to remove the springs, so it is not favoured by many doctors."

But Cooper's doctor, Mark Gianoutsos, disagreed, saying the technique allowed babies to avoid major surgery, had a lower morbidity rate than remodelling and had "shown significant advantages in the short, intermediate and long term".

"When you take the entire skull apart and remodel it, obviously it is a huge procedure, so if there are few downsides with the surgery and significant upsides for some, then I think it is a prudent philosophy." Associate Professor Gianoutsos, the director of the hospital's pediatric plastic surgery and reconstruction unit, said the technique had shown few complications and some "very gratifying results".

For Cooper's mother the procedure has already been a success.

"He's been miserable since the operation because it must hurt to lie on his head, but we've already seen a change in shape, and we've been told told it will get better and better."

© 2008 Sydney Morning Herald

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