Staged Raising of a Coronal Flap for Fronto-Orbital Advancement and Remodeling in Saethre–Chotzen Syndrome Complicated by Sinus Pericranii

This article reports the surgical management of a 3-month-old girl with Saethre–Chotzen syndrome, who presented with bicoronal synostosis and a large midline sinus pericranii with abnormal cerebral venous drainage via scalp veins. Raised intracranial pressure was demonstrated on monitoring, indicating the need for calvarial expansion necessitating a coronal access incision. A 2-staged delayed raising of the coronal flap was performed to reduce the potential risk of cerebral venous infarction. Monitoring for clinical sequelae and a computerised tomography venogram followed each of these procedures, demonstrating successful redirection of the venous drainage of the brain posteriorly. Finally, a successful fronto-orbital advancement and remodeling procedure was performed with no complications. Address correspondence and reprint requests to David Johnson, DM, MA, BMBCh, FRCS (Plast), Oxford Craniofacial Unit, West Wing, John Radcliffe Hospital, Headington, OX3 9DU, UK; E-mail: davidjohnson@doctors.org.uk Received 14 January, 2018 Accepted 1 June, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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