[Advances in the understanding of the etiopathogenesis of non syndromic craniostenoses and therapeutic approaches].

The treatment of craniostenoses has not been revolutionized over the last decade, but the methods of investigation, particularly 3D CT scan, histological studies, and refinement of techniques, have allowed substantial progress in the understanding of the aetiopathogenesis and treatment of craniostenoses. The deformities of the components of the base of the skull can now be more precisely analysed. The authors present these elements for each of the various types of craniostenosis. The role of soft tissues has been more clearly defined; the dura mater, corresponding to an internal periosteum, has an osteogenic, but also directional role. The concept of the brain as the essential determinant of cranial morphology has led to the proposal of treatments adapted to each deformity. Specific craniectomies have been completed by mobilization of flaps, and segmentation of the vault allowing almost ideal reconstruction of the skull. In most treated cases, directed osteogenesis results in good consolidation after seven to eight months; partial non-ossification remains frequent in children treated after the age of eighteen months.