Outcomes of endoscopic suturectomy with postoperative helmet therapy in bilateral coronal craniosynostosis

Rottgers, S. Alex; Lohani, Subash; Proctor, Mark R.

doi:10.3171/2016.2.peds15693

Cited by 49 publications

(46 citation statements)

References 29 publications

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“…36.3 months, which is similar to the mean follow-up of 36.8 months and 37 months reported by Han et al 8 and Rottgers et al, 20 respectively. Furthermore, Rottgers et al reported that in their series, secondary FOAs were performed an average of 15 months after endoscopic surgery, with the latest revision taking place 22.7 months after the endoscopic procedure.…”

Section: Discussionsupporting

confidence: 86%

“…An additional 18 patients with bilateral coronal craniosynostosis treated endoscopically, 9 of whom were di- agnosed with syndromic craniosynostosis, were recently reported by Rottgers and colleagues. 20 The syndromes that were involved included Saethre-Chotzen (n = 3), Apert (n = 2), Muenke (n = 3), and Pfeiffer (n = 1). Although the authors did not analyze syndromic and nonsyndromic patients separately, the overall mean age at surgery was 2.6 months.…”

Section: Discussionmentioning

confidence: 99%

“…13 Few reports, however, have described the use of endoscopic suturectomy and postoperative helmet therapy for patients with syndromic craniosynostosis. 8,10,19,20 Syndromic craniosynostosis accounts for 8%-24% of all patients with craniosynostosis. Multiple syndromes exist, many of which result from 1 or more mutations in 1 of at least 57 currently recognized genes.…”

mentioning

confidence: 99%

“…Indeed, among the few syndromic patients who are reported as having undergone endoscopic suturectomy and postoperative helmet therapy, almost half have required subsequent calvarial remodeling due to either persistent or recurrent deformity. 8,19,20 In these cases, one may question the utility of the primary surgery with helmet therapy if subsequent open surgery is ultimately required. We present our experience with this patient population and seek to identify factors that may contribute to the sufficiency of endoscopic surgery alone.…”

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confidence: 99%

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Endoscopic surgery for patients with syndromic craniosynostosis and the requirement for additional open surgery

Hersh

Hoover‐Fong²,

Beck³

et al. 2017

Journal of Neurosurgery: Pediatrics

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OBJECTIVERecent reports have described early endoscopic suturectomy as a treatment option for patients with syndromic craniosynostosis, but such patients often require subsequent calvarial remodeling. The authors describe their experience with this patient population and seek to identify predictors of sufficiency of endoscopic surgery alone.METHODSThe medical records of patients with syndromic craniosynostosis who underwent endoscopic repair were retrospectively reviewed. Demographic data, operative details, and follow-up data were collected.RESULTSA total of 6 patients with syndromic craniosynostosis underwent endoscopic surgery followed by helmet therapy during the study period. Of these, 3 patients were male. The involved syndromes included Crouzon, Pfeiffer, Jackson-Weiss, Muenke, Saethre-Chotzen, and craniosynostosis-3 (n = 1 each). The patients underwent endoscopic surgery at a median age of 2.1 months (range 0.9–4.1 months). The median estimated blood loss was 30 ml (range 20–100 ml), with 2 patients requiring a transfusion. The median length of stay in the hospital was 1.5 days (range 1–4 days), and the median follow-up was 29.0 months (range 16.8–81.7 months), with 1 patient (16.7%) requiring an open revision. Three patients (50%) were classified as Whitaker Category I at the last follow-up. The patients for whom additional open surgery was performed or recommended (Whitaker Category IV) were the oldest patients in the cohort, ranging from 2.6 to 4.1 months at the time of surgery.CONCLUSIONSThis series demonstrates that endoscopic surgery can be sufficient to treat syndromic craniosynostosis without subsequent open calvarial remodeling over a median follow-up period of at least 2 years. The findings suggest that younger age at the time of endoscopic surgery may be an important factor in determining the sufficiency of this procedure. Even among patients who require subsequent open calvarial remodeling, early endoscopic surgery may allow for growth and development of the brain and skull while delaying the need for open remodeling until the patient is older and can better tolerate the procedure.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Endoscopic surgery for patients with syndromic craniosynostosis and the requirement for additional open surgery

Hersh

Hoover‐Fong²,

Beck³

et al. 2017

Journal of Neurosurgery: Pediatrics

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“…In addition, a minimally invasive approach, especially endoscopic suturectomy, may be used in some cases to correct the positional deformities surgically. The remodeling helmets can be used for very young patients (i.e., younger than 6 months) alone or in combination with suturectomy [52][53][54].…”

Section: Treatment and Complicationsmentioning

confidence: 99%

Craniosynostosis - Recognition, clinical characteristics, and treatment

Kajdič

Spazzapan

Velnar

2017

Bosn J of Basic Med Sci

109

168

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Craniosynostosis is a developmental craniofacial anomaly, resulting in impairment of brain development and abnormally shaped skull. The main cause of craniosynostosis is premature closure of one or more cranial sutures. It usually occurs as an isolated condition, but may also be associated with other malformations as part of complex syndromes. When left untreated, craniosynostosis can cause serious complications, such as developmental delay, facial abnormality, sensory, respiratory and neurological dysfunction, anomalies affecting the eye, and psychological disturbances. Thus, early diagnosis, expert surgical techniques, postoperative care, and adequate follow-up are of vital importance in treating craniosynostosis.

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Genetic advances in craniosynostosis

Lattanzi

Barba

Pietro

et al. 2017

American J of Med Genetics Pt A

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Craniosynostosis, the premature ossification of one or more skull sutures, is a clinically and genetically heterogeneous congenital anomaly affecting approximately 1 in 2,500 live births. In most cases, it occurs as an isolated congenital anomaly, i.e. nonsyndromic craniosynostosis (NCS), the genetic and environmental causes of which remain largely unknown. Recent data suggest that at least some of the midline NCS cases may be explained by two loci inheritance. In approximately 25–30% of patients craniosynostosis presents as a feature of a genetic syndrome due to chromosomal defects or mutations in genes within interconnected signaling pathways. The aim of this review is to provide a detailed and comprehensive update on the genetic and environmental factors associated with NCS, integrating the scientific findings achieved during the last decade. Focus on the neurodevelopmental, imaging and treatment aspects of NCS is also provided.

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Outcomes of endoscopic suturectomy with postoperative helmet therapy in bilateral coronal craniosynostosis

Cited by 49 publications

References 29 publications

Endoscopic surgery for patients with syndromic craniosynostosis and the requirement for additional open surgery

Endoscopic surgery for patients with syndromic craniosynostosis and the requirement for additional open surgery

Craniosynostosis - Recognition, clinical characteristics, and treatment

Genetic advances in craniosynostosis

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