Sagittal synostosis: A review of 53 cases of sagittal suturectomy in one unit

Murray, Dylan J.; Kelleher, Michael O.; McGillivary, Anne; Allcutt, D; Earley, Michael

doi:10.1016/j.bjps.2007.02.003

Cited by 31 publications

(32 citation statements)

References 37 publications

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“…The initial postoperative CI of 75 or the 2-to 4-year postoperative CI of 73 was a good result, as compared with others. 2,4,6,12,15,18,22,23,[29][30][31][32]36,39,40,46,51 The decrease in CI that we observed over time is comparable to the limited available data on long-term outcome. 2,16 Adding a widening bridge complies with Fearon and colleagues' suggestion to overcorrect width to compensate for later growth restriction in that direction.…”

Section: Discussionsupporting

confidence: 85%

Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome

Veelen¹,

Mihajlović²,

Dammers³

et al. 2015

PED

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OBJECT Various techniques to correct sagittal synostosis have been described. The authors of this study assess the results of 2 techniques for late complete cranial remodeling and test the hypothesis that adding a widening bridge would improve outcome. METHODS In this retrospective study, the authors evaluated patients with nonsyndromic sagittal synostosis—those who underwent frontobiparietal remodeling (FBR) and those who underwent modified FBR (MFBR) involving the introduction of a bony bridge to increase the width of the skull. Outcomes for both groups are described in terms of the aesthetic results assessed on photographs and any changes in the cranial index (CI) and head circumference over time, the presence of papilledema, and complaints of headache. The effect of the surgical technique on CI and head circumference over time was assessed using linear regression analysis, with adjustment for preoperative CI and head circumference. RESULTS Sixty-nine patients with isolated sagittal synostosis were included in this study: 35 underwent MFBR and 34 underwent the original technique of FBR. The mean follow-up period was 7 years. In the 1st year after surgery, mean CI improved by 9% in the FBR group and by 12% in the MFBR group. One year after surgery, CI in the MFBR group was on average 4.7% higher than that in the FBR group (p < 0.001). During follow-up, CI decreased in both groups; however, at all time points CI was significantly higher in the MFBR group than in the FBR group. The impact of surgical technique on CI was less important than the impact of preoperative CI (R2= 0.26 vs 0.54), and this applied at all time points during follow-up. Head circumference declined during follow-up in both groups. It was influenced by preoperative head circumference, but not by surgical technique. Aesthetic outcome, prevalence of headache (42%), and papilledema (7%) were comparable in both groups. CONCLUSIONS Adding a widening bridge to late complete remodeling significantly improved CI and helped to prevent CI from decreasing in the long term. This addition did not affect the head circumference growth curve. Despite a mean head circumference remaining at +1 SD, patients continued to develop papilledema postoperatively (7%).

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Section: Discussionsupporting

confidence: 85%

Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome

Veelen¹,

Mihajlović²,

Dammers³

et al. 2015

PED

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“…Children with a normal head shape have an average CI of 75 to 80 [3,26], and scaphocephalic children typically have an average CI of 60 to 67 [4,7,9,16,25]. Our present results fall well within these ranges preoperatively (66.56), but the mean postoperative CI (70.…”

Section: Discussionsupporting

confidence: 81%

Cephalic index correlates poorly with intracranial volume in non-syndromic scaphocephalic patients

et al. 2014

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“…The postoperative CI achieved with MSC in this series is similar to that recorded in other studies of outcomes from variants of open vertex strip craniectomy. 18,[27][28][29]36,38 In these studies, CI scores were typically in the range of 70 to 74 at the most recent review reported. These outcomes, whereas an undoubted improvement over preoperative state, are still consistently lower than the general population mean, as judged by either anthropometric or cephalometric norms.…”

Section: Discussionmentioning

confidence: 93%

Long-Term Morphological Outcomes in Nonsyndromic Sagittal Craniosynostosis

Thomas

Johnson

Byren

et al. 2015

Journal of Craniofacial Surgery

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Correction of scaphocephaly is one of the principle goals of surgery in sagittal craniosynostosis. Reported relapse in head shape after surgery and continued head growth into late adolescence underscores the need for long-term outcomes to be considered when comparing between different surgical approaches in this condition; yet there are relatively few reports of results to 5 years and beyond in the literature. Therefore, a retrospective review was performed of the anthropometric data of 224 patients with sagittal craniosynostosis who underwent primary surgery between 1994 and 2012. During this period, patients underwent either a modified strip craniectomy (MSC) or calvarial remodeling (CR) procedure. Sixty-two patients were treated by MSC and followed up for a mean of 44 months. One hundred sixty-two patients had CR, with follow-up for a mean of 45 months. Overall, 90 patients were seen up to 5 years, and 47 patients to 9 years or more after surgery. The cephalic index (CI) of MSC-treated patients improved from a mean of 67.0 to 72.7, with 31% achieving a CI greater than 75 at one year. Calvarial remodeling was significantly more effective at correcting the scaphocephalic deformity. Patients treated with CR improved from a mean CI of 66.7 to 76.1. Sixty-two percent of the patients achieved a CI greater than 75. In both groups, outcomes were stable throughout follow-up with no significant relapse up to 14 years after surgery.

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Sagittal synostosis: A review of 53 cases of sagittal suturectomy in one unit

Cited by 31 publications

References 37 publications

Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome

Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome

Cephalic index correlates poorly with intracranial volume in non-syndromic scaphocephalic patients

Long-Term Morphological Outcomes in Nonsyndromic Sagittal Craniosynostosis

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