Paradigm shift in vertebral eosinophilic granuloma

Objective: Eosinophilic granuloma is the most common type of Langerhans cell histiocytosis. Vertebral bone involvement of eosinophilic granuloma is a rare disease. There are few studies in the literature on patients with vertebral bone involvement diagnosed with eosinophilic granuloma. There is still no clear protocol for the treatment of patients with vertebral involvement with eosinophilic granuloma. This article is a summary of the clinical follow-ups of our 6 cases diagnosed with spinal eosinophilic granuloma. We changed the chemotherapy protocol or extended the duration of chemotherapy in patients with progressive disease.Methods: In this study, there are six patients (4 male and 2 female) with vertebral involvement of eosinophilic granuloma in our hospital between September 2017 and August 2022. The clinical findings, radiological images, treatments and follow-up results of the patients were analyzed retrospectively.Results: In the follow-ups, a new vertebral bone involvement was observed in two patients and a femoral bone involvement was observed in another patient. One patient with neurological deficit underwent surgical treatment. Chemotherapy treatment was given to four patients with multiple bone involvement or recurrence. No recurrence was observed in three patients who started chemotherapy treatment after recurrence.Conclusions: Surgical treatment should be considered in patients with neurological deficits and spinal instability. According to the results of our study, patients with multiple bone or systemic involvement and no neurological deficit should receive chemotherapy treatment. We recommend changing the chemotherapy protocol or extending the chemotherapy duration in patients with progressive disease

Double curve linear incision approach in cases of sagittal craniosynostosis

Craniosynostosis is the premature fusion of one or more sutures in the cranial dome or anterior skull base, resulting in an abnormal head shape. This pathological process is observed less frequently in Eastern geography and approximately one in 2000 to 2500 births in Western countries. Isolated sagittal synostosis accounts for more than half of craniosynostosis cases. In our study, the duration of surgery, duration of anaesthesia, duration of hospital stay, estimated amount of bleeding during surgery and the months of surgery were examined in 16 patients. The performed craniotomy is not different from the four different craniotomies described in the literature. Strip craniectomy and barrel osteotomy were performed on each patient. According to the incisions described in the literature, the incision type and location are different. As the described incision provides less skin dissection, less bleeding and less dead space formation allows surgery in earlier months