Calvarial Reshaping: Correcting Skull Malformation
Shortly after twins Emma and Noah were born, their parents knew something was very wrong. Noah’s head was very elongated. At first, they were told he had an indent, and that his skull would shape itself as he grew. But the specialists at Detroit Medical Center’s DMC Children’s Hospital of Michigan saw something else.
Pediatric Plastic Surgeon Dr. Arlene Rozzelle could see that the soft spot on Noah’s skull had grown over, causing the head to look elongated. It was continuing to grow in this incorrect shape, and it could affect the growth of his brain.
Dr. Rozzelle is a fellowship trained, dedicate craniofacial surgeon. She diagnosed Noah with craniosynostosis, a condition in which one of the growth sutures in the skull is fused or does not form.
The skull has several of these growth sutures – places where the separate plates of bone come together. These are mobile, which allows the baby to be born, and they are also areas of rapid growth. Your head grows 10 centimeters in diameter in just the first few months of life, and that growth occurs mainly at the sutures.
But in craniosynostosis, the sutures do not form, or fuse too early, resulting in a condition like Noah’s. If the head cannot grow normally, there may be pressure on the brain. In addition, it affects the shape of the facial features – the eyes, nose and cheekbones. It must be corrected early.
Dr. Rozzelle’s procedure for this correction is called calvarial reshaping. In short, she removes the skull and reshapes it, allowing the growing brain room to expand. Once the skull is revealed, Dr. Sandeep Sood, a DMC pediatric neurosurgeon, removes the bone in three sections, which Dr. Rozzelle then reshapes. The pieces are then replaced over the brain, resulting in a dramatic difference.
The difference is noticeable immediately and recovery time for the procedure is less than a week.
Why did Dr. Rozzelle choose this specialty? “I think I chose plastic surgery because you can see your result right away, and that’s very gratifying. Also, I love children. So, for me to be able to do pediatric plastic surgery is wonderful. You never doubt at the end of the day that you’ve done something that made a difference.”