Calvarial Vault Remodeling

What is a Calvarial Vault Remodeling/Fronto-Orbital Advancement?

Calvarial vault remodeling (CVR) refers to reshaping the bones of the skull when they are misshapen due to craniosynostosis.

Fronto-orbital advancement (FOA) refers to advancing the forehead and eyebrow region forward in patients in whom those regions are recessed.

Who Needs a Calvarial Vault Remodeling/Fronto-Orbital Advancement?

CVR and FOA are used to treat children with craniosynostosis. Craniosynostosis is premature fusion of one or several of the sutures between the bones of the skull.

For coronal and metopic craniosynostosis, children usually need both a CVR and FOA, performed at the same time.

For sagittal and lambdoid craniosynostosis, children usually only need a CVR.

There are two reasons to perform CVR/FOA in children with craniosynostosis:

  1. To reshape an abnormally shaped head

  2. To allow the brain to expand by opening up the fused suture

How is a Calvarial Vault Remodeling/Fronto-Orbital Advancement Performed?

For open CVR/FOA, a zigzag incision is made in the skin of the scalp. This allows the surgeons access to the bones of the skull. The surgeons then remove the misshapen bones, reshape them, and place them back in the correct position. They are secured in place with absorbable plates and screws. The skin is then closed.

What Can I Expect After Calvarial Vault Remodeling/Fronto-Orbital Advancement?

Most children are in the hospital between three and five days after CVR/FOA. With open CVR/FOA, most children require a blood transfusion during or after surgery. With FOA, there is usually swelling of the eyelids for the first 7-10 days. Children are allowed to eat their regular diet.