Skull Reconstruction


Craniosynostosis is a medical condition in which some or all of the sutures in the skull of an infant or child close too early, causing problems with normal brain and skull growth. It can result in craniostenosis: the skull deformity caused by the premature closure of the cranial sutures.

At birth, the human skull is made up of 45 separate bony elements.  As growth occurs, many of these bony elements gradually fuse together into solid bone. The skull of a newborn is initially made up of connective tissue (fontanelles) that is moveable, which is necessary for birth and for later growth. As a child grows, ossification occurs and the fontanelles eventually form bone. The fontanelles can remain open for up to eighteen months of age.

When one or more sutures fuse prematurely, (plagiocephaly – abnormal /asymmetrical distortion of the skull) skull growth can be restricted perpendicular to the suture. If multiple sutures fuse while the brain is still increasing in size, intracranial pressure can increase. This is usually diagnosed through physical examination, x-rays and CT scans.

Fibrous Dysplasia & Bony Disorders

There are a host of bony diseases which may affect the skull and eye socket (orbit). These include; Fibrous dysplasia, a congenital, non-hereditary, progressive skeletal disorder in which normal bone is replaced with weak fibrous (scar like) and osseous tissue. Bone pain and deformities are common symptoms. More than one bone can be affected. There is no known cure for fibrous dysplasia, but affected bone can either be contoured during surgery or surgically removed and replaced with a customized bone substitute. If removal or resection is indicated Dr. Spinelli can reconstruct the missing elements by using the latest 3D imaging techniques. 

Osteomas are benign bony tumors that can be found on the skull as well as other body parts. They are very slow growing tumors and are only symptomatic if they cause breathing (sinus), vision (orbit) or hearing problems. They usually appear between late childhood and early adulthood. 

Paget ’s disease is a chronic disease usually developing in adulthood that affects normal bone growth and calcium intake by bones. The typical results are enlarged, brittle bones that grow abnormally.  The most commonly affected bones are the skull, spine, femur, pelvis, clavicle and humerus. The cause is unknown, but a genetic chromosomal disposition that is triggered by a slow viral infection has been thought to cause the disease. The infection may cause symptoms that take years to develop. The most common symptoms are bone pain, headaches, nerve pressure and an increase in head size. 

Based on your history, diagnosis, physical examination and radiologic and other studies, Dr. Spinelli will develop a personalized treatment for you.