Craniosynostosis: A multidisciplinary approach based on medical, social and demographic factors in a developing country

Puente-Espel, Jordi; Lopez, R.L. Rios-Lara y; Moreno-Álvarez, M.C.; Morel-Fuentes, E.J.J.

doi:10.1016/j.hgmx.2016.04.002

Cited by 7 publications

(14 citation statements)

References 54 publications

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“…Additionally, Table 1 , Table 1 continue, Table 1 -1 continue presents the general characteristics of the studies included in this scoping review. The majority of the articles were narrative reviews/guidelines; only three publications were original investigations, including one retrospective cohort study ( 9 ), one case-control study ( 6 ), and one descriptive/exploratory study ( 15 ). Only one study ( 2 ) mentions in detail the main oral features/dental manifestations reported in pediatric patients with NSCS.…”

Section: Resultsmentioning

confidence: 99%

“…These conditions lead to compensatory brain expansion into regions of the cranial vault that are not affected by CS, causing a cranial progressive deformity ( 5 , 12 ). Thus, there are different types of NSCS-characteristic dysmorphic head shapes with specific clinical findings, depending on the number of sutures fused and the involved regions ( 12 , 15 ). Single suture synostosis most frequently affects the sagittal suture, followed by the coronal, metopic, and lamboid sutures ( 3 , 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…General management of infants and children with NSCS is directed toward correcting and preventing progression of the skull deformity, stabilizing the elevated intracranial pressure, maintaining the airway, and supporting the feeding, optimal oral health, and eye protection ( 3 ). It is suggested that patients be managed in a specialized pediatric craniofacial center with all of the necessary medical/dental staff, technical expertise, resources, and equipment ( 15 ). The disorder is usually treated surgically soon after diagnosis to unlock and reshape the bones in order to optimize correction of the craniofacial malformations to reduce the effects of the increased intracranial pressure, and for functional and esthetic reasons ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

“…In any case, after reparative surgery, patient control and follow-up continue throughout childhood and adolescence until skeletal maturity ( 4 , 15 ). Affected children under 5 years of age are reviewed annually, whereas children over 5 years of age are seen every other year.…”

Section: Discussionmentioning

confidence: 99%

“…Diagnosis of CS in infants is based on the observation of an abnormal head shape, together clinical and image (x-ray and three-dimensional [3D] Computed Tomography [CT] scanning) assessments, together with 3D soft and bone tissue reconstructions ( 3 , 12 , 13 ). Management of CS should be assumed by a multidisciplinary craniofacial team composed of different health specialists in which the Pediatric Dentist must be involved, with the common purpose of providing a comprehensive medical care ( 3 , 6 , 10 , 14 , 15 ). Treatment of this disorder is mainly surgical, consisting of the excision of fused sutures prior to 12 months of age.…”

Section: Introductionmentioning

confidence: 99%

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Non-syndromic craniosynostosis in children: Scoping review

et al. 2018

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BackgroundCraniosynostosis (CS) is a complex condition consisting of the early fusion of one or more cranial sutures in the intrauterine stage. The affected infant exhibits abnormal head shape at time of birth or shortly thereafter. It can be observed in normal individuals (non-syndromic CS or NSCS) or as a part of a multisystem syndrome. The purposes of the present article were to carry out a scoping review on Non-Syndromic CS and to discuss the most important findings retrieved.Material and MethodsThe steps of this scoping review were as follows: first, to pose a research question; second, to identify relevant studies to answer the research question; third, to select and retrieve the studies; fourth, to chart the critical data, and finally, to collate, summarize, and report the results from the most important articles. Relevant articles published over a 20-year period were identified and retrieved from five Internet databases: PubMed; EMBASE; Cochrane Library; Google Scholar, and EBSCO.ResultsFourteen articles were finally included in the present scoping review. The following four most important clinical issues are discussed: (i) normal cranial development, clinical manifestations, and pathogenesis of NCSC; (ii) clinical evaluation of NCSC; (iii) treatment and post-surgical follow-up; and (iv) additional considerations.ConclusionsNSCS may be present with associated head shapes. Multiple early surgical reconstructive options are currently available for the disorder. Pediatric Dentistry practitioners must be familiarized with this condition and form part of a multi-approach health team as those responsible for the opportune oral health care of the affected child. Key words:Craniosynostosis, cranial development, children, scoping review, dental management.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-syndromic craniosynostosis in children: Scoping review

et al. 2018

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Low-Cost Desktop-Based Three-Dimensional-Printed Patient-Specific Craniofacial Models in Surgical Counseling, Consent Taking, and Education of Parent of Craniosynostosis Patients: A Comparison With Conventional Visual Explanation Modalities

Alshomer

Alfaqeeh

Alariefy

et al. 2019

Journal of Craniofacial Surgery

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Background: Craniosynostosis is a complex craniofacial deformity. Surgical decision, if needed, is always hard on the parent and requires the use of multimodalities of explanation. To the authors’ knowledge, there have been no studies tackling family counseling about the deformity and surgical decision-making process with the use of low-cost patient-specific three-dimensional (3D)-printed models. Methods: A cross-sectional study investigating the utility of patient-specific 3D-printed models using a desktop-based 3D printer. Questionnaire was constructed and validated screening the demographics, knowledge, expectation, and surgical decision-making process supplied using Likert. Data were collected consecutively from each parent first after explanation with conventional 3D computed tomography (CT) images, and then repeated after the 3D-printed model has been presented. Results: Fourteen parents were screened. Majority of parents considered the pathology to have a potential effect of child's functional and aesthetic outcomes. After using the 3D-printed models, the participants had a clear vision and needed not to read any more about the condition (P = 0.05, P = 0.019, respectively). Agreement for surgical management was in favor of the 3D-printed models compared with CT images (P = 0.028). Explanation with CT images yielded higher mean score in knowledge about potential complications compared with 3D models (P value = 0.007). For the 3D models, average printing time was 26 hours, and a mean cost of 5.2$. Conclusion: The utility of desktop 3D printing is an affordable modality to provide adequate information about craniosynostosis and can assist surgical decision-making. Knowledge and adaptation of such cheap technology represents a great skill aiding clinical practice.

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Impact of a Multidisciplinary Craniofacial Clinic for Patients With Craniofacial Syndromes on Patient Satisfaction and Outcome

Hoffman

Yuan

Boyke

et al. 2020

The Cleft Palate Craniofacial Journal

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Objective: Multidisciplinary clinics are becoming widely utilized. Given the number of patients with craniofacial syndromes evaluated at our institution, and the burden of assessment by multiple subspecialists, we created an American Cleft Palate-Craniofacial Association–certified Craniofacial Multidisciplinary Clinic (CMC) composed of a nurse practitioner, neurosurgeon, plastic surgeon, otolaryngologist, oromaxillofacial surgeon, geneticist, pulmonologist, occupational therapist, dentist, and child life specialist to improve patient experience, lessen the burden of assessment, decrease time to surgery, and improve patients’ understanding of the diagnosis and treatment plan specifically for patients with complex craniofacial syndromes. We reviewed the impact of this clinic after 1 year of implementation. Design: Retrospective review was performed to identify patients with craniofacial syndromic diagnoses seen by the neurosurgery department before and after implementation of the CMC from February 2017 to present. Setting: The CMC is an outpatient clinic based in a tertiary care academic institution. Patients: Chart review was performed to identify demographic, diagnostic, clinical, and treatment data. We assessed clinic experience, and the impact on quality of clinical and surgical care was assessed via survey. We compared this cohort to patients with similar craniofacial syndromes treated prior to the CMC. Thirty patients seen at the CMC were identified, and data from a comparable cohort of 30 patients seen prior to the clinic’s inception was reviewed. Results: Our CMC survey response rate was 67% (n = 20/30) for the CMC patients. Second opinions sought by parents prior to CMC was higher (mean = 0.85, range: 0-3) than for patients seen at the CMC (mean = 0.16, range: 0-1). Mean time to surgery before the CMC was 10.1 months (range: 1-15) compared to 4 months (range: 3-5) after implementation. Parents agreed that they felt well-informed about their diagnosis (n = 18/20, 90%), and that the presence of a plastic surgeon (19/20, 95%) and a nurse practitioner (17/20, 85%) were valuable in coordination of their care. Following surgery, 76% (n = 13/17) of patients who received surgery were happy with the outcome, 76% (n = 13/17) were happy with the appearance of the scar, and 95% (n = 19/20) would recommend the CMC to others. Conclusion: Multidisciplinary evaluation of patients with complex craniofacial conditions provides comprehensive, efficient, and effective care, as well as improved parent satisfaction and knowledge base.

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Craniosynostosis: A multidisciplinary approach based on medical, social and demographic factors in a developing country

Abstract: Please cite this article in press as: Puente-Espel J, et al. Craniosynostosis: A multidisciplinary approach based on medical, social and demographic factors in a developing country. Rev Med Hosp Gen Méx. 2016. http://dx.

Cited by 7 publications

References 54 publications

Non-syndromic craniosynostosis in children: Scoping review

Non-syndromic craniosynostosis in children: Scoping review

Low-Cost Desktop-Based Three-Dimensional-Printed Patient-Specific Craniofacial Models in Surgical Counseling, Consent Taking, and Education of Parent of Craniosynostosis Patients: A Comparison With Conventional Visual Explanation Modalities

Impact of a Multidisciplinary Craniofacial Clinic for Patients With Craniofacial Syndromes on Patient Satisfaction and Outcome

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