“N-Butyl Cyanoacrylate in reshaping of deformed forehead in patients with plagiocephaly”

BACKGROUND: Craniosynostosis is the premature fusion of one or more of the calvarial sutures, resulting in an abnormal head shape and increased intracranial pressure. Its incidence is estimated to be 1 in 2,000 births. Most of the cases are sporadic, with only 8% being syndromic or familial. OBJECTIVE: The aim of the study was to evaluate the use of N-Butyl Cyanoacrylate in combination with sutures for fixation and maintenance of bone remodeling in patients who underwent surgery for anterior plagiocephaly. METHODS: This retrospective study was conducted in two departments; Neurosurgery Department, and Maxillofacial & Plastic Surgery Department, Alexandria University, Egypt, including 19 patients who underwent surgery for correction of pla - giocephaly between January 2015 and January 2020. N-Butyl Cyanoacrylate was used in combination with 2-0 polydioxanone suture as a method for maintenance of bone remodeling in the operated subjects. Surgical outcome was assessed by the expanded Whitaker classification and the degree of parental satisfaction. RESULTS: The mean age at surgery was 6.47 months and the mean follow-up period was 24 months with a minimum of 18 months follow-up. None of our patients had major complications. One patient had infection postoperatively that resolved in two weeks. According to the Whitaker grading, 13 patients had excellent results and classified as “Whitaker grade I”, 4 patients had slight supraorbital elevation and 2 patients had an ipsilateral temporal constriction “Whitaker grade IIA”, but no further intervention was done. None of our patients required reoperation for correction of a surgical relapse. CONCLUSION: Fronto-orbital advancement with slight overcorrection, together with the use of N-Butyl Cyanoacrylate for maintenance of bone shape after remodeling and bone fixation are safe and provide satisfactory and stable aesthetic results.