Ongoing progress in the care of children with a type of skull deformity called craniosynostosis is highlighted in the special January issue of The Journal of Craniofacial Surgery. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

The twenty articles in the special issue present advances and updates in a wide range of topics concerned with the assessment, reconstructive surgery, and long-term follow-up of children with craniosynostosis. “Craniosynostosis” refers to various conditions in which the joints (sutures) between the bones of the skull close prematurely, resulting in abnormal growth of the skull and brain. Craniofacial surgeons, in concert with other professionals, design effective treatments to correct the skull deformity, prevent complications, and promote good long-term functioning.

High-Tech Advances
Topics in the special issue include new approaches to evaluation and measurement of skull deformities caused by craniosynostosis and related conditions. Recent advances include the use of three-dimensional virtual reality displays and “stereolithographic” models created using data from computed tomography (CT) scans, for use in treatment planning. Innovative surgical techniques for managing specific forms of craniosynostosis, including rare deformities, are presented as well.

A new frontier is the development of advanced surgical techniques and materials. One paper describes initial experience with a new synthetic material as an alternative to bone grafts; promising results with a tissue-engineered “osteogenic” (bone-producing) material are reported as well. Another study demonstrates that high-tech advances can have benefits on the human scale: newer “minimally invasive” approaches to surgery are shown to reduce the high stress levels experienced by parents of children with craniosynostosis.

After these extremely complex surgeries, careful follow-up is essential to ensure appropriate good form and function of the reconstructed skull as the child grows. One paper highlights the need for close monitoring for signs of visual damage related to excess pressure within the skull.

Positional Plagiocephaly
Several papers address a separate problem called positional plagiocephaly—flattening of the back of the skull in infants. Positional plagiocephaly is a much less serious condition than craniosynostosis, but has been more frequent since the recommendation to lay babies on their backs to sleep to prevent sudden infant death syndrome (SIDS). In most cases, plagiocephaly is treated using a special helmet to help “mold” the growing skull. A new study adds to research demonstrating the good results of molding helmet therapy, with high parental satisfaction rates and good quality-of-life scores.

One paper raises the possibility that the use of excessively high doses of folic acid by women planning to become pregnant may increase the risk of positional plagiocephaly, although the results are inconclusive. Another report shows that, in a small number of children, some forms of craniosynostosis may at first be mistakenly diagnosed as plagiocephaly.

Editor Stresses Long-Term Outcomes
The diverse papers in the special issue illustrate the drive for continued improvement and excellence that characterizes craniofacial surgery, according to a Special Editorial by Dr. Mutaz B. Habal, Director of Tampa Bay Craniofacial Center in Tampa, Fla., and Editor-in-Chief of The Journal of Craniofacial Surgery. Dr. Habal highlights the need for an ongoing focus not just on reconstructing the skull structure, but also on achieving good long-term functional outcomes for patients with skull deformities. He writes, “We look for a common vision, pursuit of performance measures, quality and safety and orient our thinking to long-term clinical outcomes.”

About The Journal of Craniofacial Surgery
The Journal of Craniofacial Surgery serves as a forum of communication for all those involved in craniofacial and maxillofacial surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. Affiliates include 13 major specialty societies around the world, including the American Association of Pediatric Plastic Surgeons, the American Academy of Pediatrics Section of Pediatric Plastic Surgery, the American Society of Craniofacial Surgeons, the American Society of Maxillofacial Surgeons, the Argentine Society of Plastic Surgery Section of Pediatric Plastic Surgery, the Asian Pacific Craniofacial Association, the Brazilian Society of Craniofacial Surgeons, the European Society of Craniofacial Surgery, the International Society of Craniofacial Surgery, the Japanese Society of Craniofacial Surgery, the Korean Society of Craniofacial Surgery, the Thai Cleft and Craniofacial Association, and the World Craniofacial Foundation.

About Wolters Kluwer Health
Wolters Kluwer Health (Conshohocken, PA), a division of Wolters Kluwer, is a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Major brands include traditional publishers of medical and drug reference tools and textbooks, such as Lippincott Williams & Wilkins and Facts & Comparisons; electronic information providers, such as Ovid Technologies, Medi-Span and ProVation; and pharmaceutical information providers Adis International and Source®. For more information, visit WKHealth.com.

About Wolters Kluwer
Wolters Kluwer is a leading global information services and publishing company. The company provides products and services for professionals in the health, tax, accounting, corporate, financial services, legal, and regulatory sectors. Wolters Kluwer has 2006 annual revenues of €3.4 billion, employs approximately 18,450 people worldwide, and maintains operations across Europe, North America, and Asia Pacific. Wolters Kluwer is headquartered in Amsterdam, the Netherlands. Its shares are quoted on the Euronext Amsterdam (WKL) and are included in the
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Source: Wolters Kluwer Health: Lippincott Williams & Wilkins