Does Coronal Suturectomies and Occipital Barrel Staves Make a Difference in Early Reconstruction for Sagittal Craniosynostosis?

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jesper Unander-Scharin ◽  
Arja Heliövaara ◽  
Per Enblad ◽  
Junnu Leikola ◽  
Daniel Nowinski
Keyword(s):  
Sagittal Craniosynostosis ◽  
Early Reconstruction

Age at the Time of Surgery and Maintenance of Head Size in Nonsyndromic Sagittal Craniosynostosis

2016 ◽  
Vol 137 (5) ◽  
pp. 1557-1565 ◽  
Author(s):  
Curtis S. Bergquist ◽  
Allison C. Nauta ◽  
Nathan R. Selden ◽  
Anna A. Kuang
Keyword(s):  
Head Size ◽  
Time Of Surgery ◽  
Sagittal Craniosynostosis

scholarly journals Ophthalmological findings in children with non-syndromic craniosynostosis: preoperatively and postoperatively up to 12 months after surgery

2021 ◽  
Vol 6 (1) ◽  
pp. e000677
Author(s):  
Evangelia Ntoula ◽  
Daniel Nowinski ◽  
Gerd Holmstrom ◽  
Eva Larsson
Keyword(s):  
Visual Acuity ◽  
University Hospital ◽  
Cranial Sutures ◽  
Sagittal Craniosynostosis ◽  
Syndromic Craniosynostosis ◽  
Disc Oedema ◽  
Before And After ◽  
Congenital Condition ◽  
Skull Deformity

AimsCraniosynostosis is a congenital condition characterised by premature fusion of one or more cranial sutures. The aim of this study was to analyse ophthalmic function before and after cranial surgery, in children with various types of non-syndromic craniosynostosis.MethodsChildren referred to Uppsala University Hospital for surgery of non-syndromic craniosynostosis were examined preoperatively. Visual acuity was measured with Preferential Looking tests or observation of fixation and following. Strabismus and eye motility were noted. Refraction was measured in cycloplegia and funduscopy was performed. Follow-up examinations were performed 6–12 months postoperatively at the children’s local hospitals.ResultsOne hundred twenty-two children with mean age 6.2 months were examined preoperatively. Refractive values were similar between the different subtypes of craniosynostosis, except for astigmatism anisometropia which was more common in unicoronal craniosynostosis. Strabismus was found in seven children, of which four had unicoronal craniosynostosis.Postoperatively, 113 children were examined, at mean age 15.9 months. The refractive values decreased, except for astigmatism and anisometropia in unicoronal craniosynostosis. Strabismus remained in unicoronal craniosynostosis. Two new cases with strabismus developed in unicoronal craniosynostosis and one in metopic, all operated with fronto-orbital techniques. No child had disc oedema or pale discs preoperatively or postoperatively.ConclusionOphthalmic dysfunctions were not frequent in children with sagittal craniosynostosis and preoperative ophthalmological evaluation may not be imperative. Children with unicoronal craniosynostosis had the highest prevalence of strabismus and anisometropia. Fronto-orbital techniques used to address skull deformity may be related to a higher prevalence of strabismus postoperatively.

Meningioma and Sagittal Craniosynostosis in an Infant

Neurosurgery ◽  
1992 ◽  
Vol 30 (3) ◽  
pp. 441-442 ◽  
Author(s):  
William M. Chadduck ◽  
Frederick A. Boop ◽  
James B. Blankenship ◽  
Muhammad Husain
Keyword(s):  
Sagittal Craniosynostosis

EARLY RECONSTRUCTION OF THE ELBOW FOLLOWING SEVERE TRAUMA

1970 ◽  
Vol 10 (10) ◽  
pp. 839-852 ◽  
Author(s):  
WILLIAM J. POLLOCK ◽  
JAMES C. PARKES
Keyword(s):  
Severe Trauma ◽  
Early Reconstruction

Endoscopically assisted versus open repair of sagittal craniosynostosis: the St. Louis Children's Hospital experience

2011 ◽  
Vol 8 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Manish N. Shah ◽  
Alex A. Kane ◽  
J. Dayne Petersen ◽  
Albert S. Woo ◽  
Sybill D. Naidoo ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Loss ◽  
Open Surgery ◽  
Operating Time ◽  
Endoscopic Procedure ◽  
Sagittal Craniosynostosis ◽  
Helmet Therapy ◽  
Age At Surgery ◽  
The Mean ◽  
Strip Craniectomy

Object This study investigated the differences in effectiveness and morbidity between endoscopically assisted wide-vertex strip craniectomy with barrel-stave osteotomies and postoperative helmet therapy versus open calvarial vault reconstruction without helmet therapy for sagittal craniosynostosis. Methods Between 2003 and 2010, the authors prospectively observed 89 children less than 12 months old who were surgically treated for a diagnosis of isolated sagittal synostosis. The endoscopic procedure was offered starting in 2006. The data associated with length of stay, blood loss, transfusion rates, operating times, and cephalic indices were reviewed. Results There were 47 endoscopically treated patients with a mean age at surgery of 3.6 months and 42 patients with open-vault reconstruction whose mean age at surgery was 6.8 months. The mean follow-up time was 13 months for endoscopic versus 25 months for open procedures. The mean operating time for the endoscopic procedure was 88 minutes, versus 179 minutes for the open surgery. The mean blood loss was 29 ml for endoscopic versus 218 ml for open procedures. Three endoscopically treated cases (6.4%) underwent transfusion, whereas all patients with open procedures underwent transfusion, with a mean of 1.6 transfusions per patient. The mean length of stay was 1.2 days for endoscopic and 3.9 days for open procedures. Of endoscopically treated patients completing helmet therapy, the mean duration for helmet therapy was 8.7 months. The mean pre- and postoperative cephalic indices for endoscopic procedures were 68% and 76% at 13 months postoperatively, versus 68% and 77% at 25 months postoperatively for open surgery. Conclusions Endoscopically assisted strip craniectomy offers a safe and effective treatment for sagittal craniosynostosis that is comparable in outcome to calvarial vault reconstruction, with no increase in morbidity and a shorter length of stay.

Postoperative Cranial Vault Growth in Premature Sagittal Craniosynostosis

2013 ◽  
Vol 24 (1) ◽  
pp. 146-149 ◽  
Author(s):  
Philipp Metzler ◽  
Wolfgang Zemann ◽  
Christine Jacobsen ◽  
Klaus Wilhelm Grätz ◽  
Joachim Anton Obwegeser
Keyword(s):  
Cranial Vault ◽  
Sagittal Craniosynostosis

Comparison of aesthetic outcomes between open and endoscopically treated sagittal craniosynostosis

2021 ◽  
pp. 1-7
Author(s):  
Jacob Lepard ◽  
S. Hassan A. Akbari ◽  
James Mooney ◽  
Anastasia Arynchyna ◽  
Samuel G. McClugage III ◽  
...  
Keyword(s):  
Head Circumference ◽  
Endoscopic Treatment ◽  
Open Repair ◽  
Perioperative Outcomes ◽  
Subjective Rating ◽  
Cephalic Index ◽  
Sagittal Synostosis ◽  
Sagittal Craniosynostosis ◽  
Subjective Assessments ◽  
Z Scores

OBJECTIVE In the last several decades, there has been much debate regarding the ideal treatment for sagittal synostosis. The purpose of this study was to compare perioperative, anthropometric, and subjective assessments of cosmetic outcomes between open and endoscopic management of isolated sagittal synostosis. METHODS At their routine postoperative follow-up, pediatric patients with sagittal craniosynostosis were recruited to undergo digital cranial measurement and standardized photography for objective and subjective assessments of perioperative outcomes. Age-normalized z-scores for cephalic index, head circumference, euryon-euryon diameter (Eu-Eu), and glabella-opisthocranion diameter (G-Op) were calculated for each patient. Faculty surgeons, surgical trainees, nurses, and laypersons were asked to rate the normalcy of craniofacial appearances using a 5-point Likert scale. Outcomes were compared between patients treated with endoscopic correction and those treated with open repair. RESULTS A total of 50 patients were included in the study. Thirty-one had undergone open surgical correction, and 19 had undergone endoscopic treatment. Endoscopic repair involved significantly lower operative time, blood loss, transfusion rate, and hospital length of stay than those with open repair (p < 0.001). There was no significant difference between groups in terms of z-scores for head circumference (p = 0.22), cephalic index (p = 0.25), or Eu-Eu (p = 0.38). Endoscopic treatment was associated with a significantly lower G-Op (p = 0.009). Additionally, the average subjective rating of head shape was higher for endoscopic treatment when corrected for age, gender, and ethnicity (p = 0.02). CONCLUSIONS The study findings suggest that patients who are treated endoscopically may have an overall more normal appearance in skull morphology and cosmesis, although these results are limited by poor reliability.

scholarly journals One hundred consecutive endoscopic repairs of sagittal craniosynostosis: an evolution in care

2017 ◽  
Vol 20 (5) ◽  
pp. 410-418 ◽  
Author(s):  
Dennis C. Nguyen ◽  
Scott J. Farber ◽  
Gary B. Skolnick ◽  
Sybill D. Naidoo ◽  
Matthew D. Smyth ◽  
...  
Keyword(s):  
Blood Loss ◽  
Patient Care ◽  
Length Of Hospital Stay ◽  
Successful Outcome ◽  
Emissary Vein ◽  
Sagittal Craniosynostosis ◽  
Care Protocol ◽  
Estimated Blood Loss ◽  
Helmet Therapy ◽  
The Mean

OBJECTIVEEndoscope-assisted repair of sagittal craniosynostosis was adopted at St. Louis Children’s Hospital in 2006. This study examines the first 100 cases and reviews the outcomes and evolution of patient care protocols at our institution.METHODSThe authors performed a retrospective chart review of the first 100 consecutive endoscopic repairs of sagittal craniosynostosis between 2006 and 2014. The data associated with length of hospital stay, blood loss, transfusion rates, operative times, cephalic indices (CIs), complications, and cranial remolding orthosis were reviewed. Measurements were taken from available preoperative and 1-year postoperative 3D reconstructed CT scans.RESULTSThe patients’ mean age at surgery was 3.3 ± 1.1 months. Of the 100 patients, 30 were female and 70 were male. The following perioperative data were noted. The mean operative time (± SD) was 77.1 ± 22.2 minutes, the mean estimated blood loss was 34.0 ± 34.8 ml, and the mean length of stay was 1.1 ± 0.4 days; 9% of patients required transfusions; and the mean pre- and postoperative CI values were 69.1 ± 3.8 and 77.7 ± 4.2, respectively. Conversion to open technique was required in 1 case due to presence of a large emissary vein that was difficult to control endoscopically. The mean duration of helmet therapy was 8.0 ± 2.9 months. Parietal osteotomies were eventually excluded from the procedure.CONCLUSIONSThe clinical outcomes and improvements in CI seen in our population are similar to those seen at other high-volume centers. Since the inception of endoscope-assisted repair at our institution, the patient care protocol has undergone several significant changes. We have been able to remove less cranium using our “narrow-vertex” suturectomy technique without affecting patient safety or outcome. Patient compliance with helmet therapy and collaborative care with the orthotists remain the most essential aspects of a successful outcome.

scholarly journals The preoperative incidence of raised intracranial pressure in nonsyndromic sagittal craniosynostosis is underestimated in the literature

2014 ◽  
Vol 14 (6) ◽  
pp. 674-681 ◽  
Author(s):  
Steven A. Wall ◽  
Gregory P. L. Thomas ◽  
David Johnson ◽  
Jo C. Byren ◽  
Jayaratnam Jayamohan ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Nonoperative Management ◽  
Raised Intracranial Pressure ◽  
Corrective Surgery ◽  
Icp Monitoring ◽  
Noninvasive Method ◽  
Radiological Findings ◽  
Indication For Surgery ◽  
Sagittal Craniosynostosis ◽  
Significant Difference

Object The presence of raised intracranial pressure (ICP) in untreated nonsyndromic, isolated sagittal craniosynostosis (SC) is an important functional indication for surgery. Methods A retrospective review was performed of all 284 patients presenting with SC to the Oxford Craniofacial Unit between 1995 and 2010. Results Intraparenchymal ICP monitoring was performed in 39 children following a standard unit protocol. Monitoring of ICP was offered for all patients in whom nonoperative management was considered on the basis of minimal deformity or in cases in which parents were reluctant to agree to corrective surgery. These patients presented at an older age than the rest of the cohort (mean age 56 months), with marked scaphocephaly (16/39, 41%), mild scaphocephaly (11, 28%), or no scaphocephalic deformity (12, 31%). Raised ICP was found in 17 (44%) patients, with no significant difference in its incidence among the 3 different deformity types. Raised ICP was not predicted by the presence of symptoms of ICP or developmental delay or by ophthalmological or radiological findings. Conclusions The incidence of raised ICP in SC reported here is greater than that previously published in the literature. The lack of a reliable noninvasive method to identify individuals with elevated ICP in SC mandates consideration of intraparenchymal ICP monitoring in all patients for whom nonoperative management is contemplated.

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