Endoscope-assisted repair of metopic synostosis

Erşahin, Yusuf

doi:10.1007/s00381-013-2286-2

Cited by 19 publications

(10 citation statements)

References 29 publications

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“…4,32 The purpose of this work was to ascertain the incidence of intra- and postoperative complications in a single center. Although a number of studies have reported on various metrics of success in endoscopic 10,13,15 or open 9,28 craniosynostosis surgeries, few have directly compared results of the two on a large cohort of patients. 6,17 We present a retrospective study examining complications after surgery in non-syndromic and syndromic cases of craniosynostosis.…”

Section: Introductionmentioning

confidence: 99%

Characterization of complications associated with open and endoscopic craniosynostosis surgery at a single institution

Han¹,

Nguyen²,

Brück³

et al. 2016

PED

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OBJECT The authors present a retrospective cohort study examining complications in patients undergoing surgery for craniosynostosis using both minimally invasive endoscopic and open approaches. METHODS Over the past 10 years, 295 nonsyndromic patients (140 undergoing endoscopic procedures and 155 undergoing open procedures) and 33 syndromic patients (endoscopic procedures in 10 and open procedures in 23) met the authors’ criteria. Variables analyzed included age at surgery, presence of a preexisting CSF shunt, skin incision method, estimated blood loss, transfusions of packed red blood cells, use of intravenous steroids or tranexamic acid, intraoperative durotomies, procedure length, and length of hospital stay. Complications were classified as either surgically or medically related. RESULTS In the nonsyndromic endoscopic group, the authors experienced 3 (2.1%) surgical and 5 (3.6%) medical complications. In the nonsyndromic open group, there were 2 (1.3%) surgical and 7 (4.5%) medical complications. Intraoperative durotomies occurred in 5 (3.6%) endoscopic and 12 (7.8%) open cases, were repaired primarily, and did not result in reoperations for CSF leakage. Similar complication rates were seen in syndromic cases. There was no death or permanent morbidity. Additionally, endoscopic procedures were associated with significantly decreased estimated blood loss, transfusions, procedure length, and length of hospital stay compared with open procedures. CONCLUSIONS Rates of intraoperative durotomies and surgical and medical complications were comparable between endoscopic and open techniques. This is the largest direct comparison to date between endoscopic and open interventions for synostosis, and the results are in agreement with previous series that endoscopic surgery confers distinct advantages over open surgery in appropriate patient populations.

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Section: Introductionmentioning

confidence: 99%

Characterization of complications associated with open and endoscopic craniosynostosis surgery at a single institution

Han¹,

Nguyen²,

Brück³

et al. 2016

PED

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“…In light of this troublesome disparity, we suggest that there remains insufficient clinical evidence to summarily declare that endoscopic strip craniectomy is ''safe'' with ''minimal'' risks. 23,25,26,29 One notable limitation of the endoscopic approach is the complete dependence on strict postoperative helmet therapy, which typically lasts for 6 to 9 months or longer. 26,30 Conceptually, helmet therapy facilitates an optimal head shape by directing the growth of the brain and calvarium after excision of the synostosed suture.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Strip Craniectomy for Craniosynostosis

Kung

Vercler

Muraszko

et al. 2016

Journal of Craniofacial Surgery

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Endoscopic strip craniectomy with postoperative helmet therapy has been introduced as a means to correct various forms of craniosynostosis. Although some authors have deemed the procedure safe and effective, many questions remain regarding this promising yet developing approach. The authors discuss 4 cases where patients were inadequately treated with endoscopic strip craniectomy resulting in a recommendation of complete secondary open cranial vault reconstruction. In addition, the authors present the findings from an informal survey of craniofacial colleagues to highlight an important discrepancy between published and anecdotal reports of complications. Finally, the authors highlight the need for further investigation into the proper indications and clinical outcomes of endoscopic strip craniectomy to better understand the role of this technique in the treatment of craniosynostosis.

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“…Different methods have been attempted in order to decrease blood loss and to prevent transfusion complications. Even though there have been many efforts to improve blood sparing during craniosynostosis surgery, including minimally invasive and endoscopic techniques (6,10,12,14), the use of autologous blood obtained from the patient in the preoperative period (11), intraoperative aminocaproic acid (17), tranexamic acid (4,8), preoperative recombinant human erythropoietin (15) and fibrin glue (25) applications, there is no concise or universally accepted procedure yet.…”

Section: █ Discussionmentioning

confidence: 99%

The management of blood loss in non-syndromic craniosynostosis patients undergoing barrel stave osteotomy

Küçük

Tümtürk²,

Gergin³

et al. 2015

Turkish Neurosurgery

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ABSTRACTare used in an attempt to keep the body temperature stable and it may be monitored continuously by a probe. However, it is nearly impossible to objectively evaluate the amount of bleeding in the calvarium while undergoing a barrel stave osteotomy. Therefore, the intraoperative observations of the surgeon, his experience, and his communication with the anesthetist and monitoring of vital signs are important in determining perioperative blood and fluid losses (13).Our aim was to evaluate blood loss and administration of blood products in patients being operated on to treat craniosynostosis, while taking age, body weight, type of craniosynostosis, preoperative and postoperative hemoglobin and hematocrit levels in to consideration. █ INTRODUCTION C raniosynostosis is the early and pathologic closure of one or more sutures in the cranium, generally causing an abnormal appearance (21). Although craniosynostosis cases are referred to a physician for cosmetic reasons, the main aim of neurosurgeons in treating craniosynostosis is to relieve an increase in potential intracranial pressure on the neural tissues and prevent and or treat disorders of cognitive function. Thus, a widely used procedure in neurosurgery, barrel stave osteotomy, is applied to the majority of craniosynostosis cases. Hypothermia and hypovolemia are the most important causes of morbidity and mortality in surgical interventions of craniosynostosis (18). During surgery, heating blankets AIm: Barrel stave osteotomy is a widely used procedure in neurosurgery for the majority of craniosynostosis patients. Both in the intraoperative and postoperative periods, there is inevitable leakage type bleeding from the bones undergoing osteotomy. A number of studies have been performed in order to prevent this complication but a concise procedure is still lacking. mATERIAl and mEThODS: Synostectomy and parietotemporal barrel stave osteotomy were applied to 143 patients who were operated on with a diagnosis of craniosynostosis between the years 2005-2013. At the beginning to osteotomy, 5 ml/kg erythrocyte suspension (ES) was given for probable blood loss. Whole blood count was performed at the postoperative 1 st and 6 th hours and cases with hemoglobin levels below 10 or with hematocrit levels which had decreased more than 5% between the 1 st and 6 th hours were administered erythrocyte transfusion. RESUlTS:Of the patients, 100 were boys and 43 were girls. Of these, 98 had metopic, 30 had sagittal, 9 had metopic+sagittal, 4 had unilateral, 2 had bilateral and 6 had coronal synostosis. All the cases were administered intraoperative erythrocyte suspension. The preoperative amount of administered mean erythrocyte was 8.61 ml/kg. In the postoperative period, 92 patients were administered erythrocyte suspension. The postoperative amount of administered mean erythrocyte suspension was 7.98 ml/kg. CONClUSION:For an operated infant with craniosynostosis who is operated on in the first year of life, undergoing osteotomy and inevitable bone-borne blood losses are very i...

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Endoscope-assisted repair of metopic synostosis

Abstract: Endoscope-assisted repair of metopic synostosis is safe and offers promising results in infants before the age of 6 months. Molding helmet therapy following surgery is very important in obtaining the good results. Early diagnosis and referral for surgery are crucial.

Cited by 19 publications

References 29 publications

Characterization of complications associated with open and endoscopic craniosynostosis surgery at a single institution

Characterization of complications associated with open and endoscopic craniosynostosis surgery at a single institution

Endoscopic Strip Craniectomy for Craniosynostosis

The management of blood loss in non-syndromic craniosynostosis patients undergoing barrel stave osteotomy

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