Treatment of unilateral coronal synostosis by endoscopic strip craniectomy or fronto-orbital advancement: Ophthalmologic findings

MacKinnon, Sarah; Rogers, Gary F.; Gregas, Matt; Proctor, Mark R.; Mulliken, John B.; Dagi, Linda R.

doi:10.1016/j.jaapos.2008.10.011

Cited by 56 publications

(41 citation statements)

References 20 publications

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“…The endoscopic craniectomy does not affect any of the muscular attachments and allows for proper orbital repositioning with maintenance of extraocular muscle balance. 22 Arguments for earlier treatment are supported by Denis et al 2 who reported a decrease in the incidence of strabismus from 67% to 19% by decreasing the mean age of corrective frontoorbital advancement from 23 months to 5.6 months. In our series only 7 (6.4%) of the 109 patients have required the need for surgical correction of strabismus (Fig.…”

Section: Discussionmentioning

confidence: 96%

“…The estimated incidence of V-pattern strabismus has been reported as 81%, 28 50%, 7 and 57.6% 21 in different studies. In a recent study comparing the ophthalmological findings of endoscopic strip craniectomy versus frontoorbital advancement, MacKinnon et al 22 found that the endoscopic craniectomy patients developed less severe V-pattern strabismus, excyclotorsion of the fundus, and range of aniso-astigmatisms. The authors argue for early treatment versus later frontoorbital advancement.…”

Section: Discussionmentioning

confidence: 99%

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Early treatment of coronal synostosis with endoscopy-assisted craniectomy and postoperative cranial orthosis therapy: 16-year experience

Jimenez¹,

Barone²

2013

PED

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Object The objective of this study was to present the authors' 16-year experience treating coronal craniosynostosis in infants using endoscopy-assisted techniques and postoperative cranial orthoses. Methods A total of 128 synostosed coronal sutures in 115 patients were treated between 1996 and 2012 by endoscopically resecting a strip of bone containing the stenosed suture via a 2–3 cm incision made at the ipsilateral stephanion. Data were obtained from a prospective database. Following surgery, patients were fitted with custom cranial orthoses to help correct preoperative craniofacial deformities. All patients were followed closely with cranial anthropometric measurements and photographs. Results The estimated mean blood loss was 20 ml (range 5–120 ml) and the estimated mean strip size was 0.6 cm × 10.7 cm. The mean surgical duration was 55 minutes (range 22–150 minutes). One patient underwent an intraoperative blood transfusion and 1 had a postoperative blood transfusion, for a total transfusion rate of 1.7%. Ninety-seven percent of patients were discharged on the first postoperative day. There were no deaths. Vertical dystopia correction of more than 80% from baseline was obtained in almost two-thirds of patients, with 51% achieving 100% correction. Nasal and sagittal craniofacial deviation (vertex-nasion-gnathion) correction greater than 80% was achieved in 80% of patients, with 77% achieving 100% correction. Supraorbital rim advancement of the ipsilateral eye was obtained in 98% of cases, with correction of frontal plagiocephaly the last deformity to achieve correction. Conclusions Early treatment of coronal synostosis with endoscopy-assisted craniectomy and postoperative molding helmets leads to significant correction of craniofacial abnormalities, including vertical dystopia, nasal deviation, sagittal misalignment, and ipsilateral proptosis. This treatment method is associated with minimal trauma, blood loss, and transfusion rates, and typically only requires 1 overnight stay. This surgical approach is safe, effective, and associated with excellent results.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Early treatment of coronal synostosis with endoscopy-assisted craniectomy and postoperative cranial orthosis therapy: 16-year experience

Jimenez¹,

Barone²

2013

PED

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“…Fundus torsion was graded on a 0–4+ scale, based on our previously reported standard, and appraised clinically while the patient gazed at the dimmed indirect headlight with his head supported in primary position; fundus torsion was confirmed with fundus photos taken, as well, in primary position 6 11…”

Section: Methodsmentioning

confidence: 99%

Rectus muscle excyclorotation and V-pattern strabismus: a quantitative appraisal of clinical relevance in syndromic craniosynostosis

et al. 2017

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“…MacKinnon 286 describes 37 patients with unicoronal craniosynostosis who all showed strabismus, of whom 20 mild, 10 moderate, and 7 severe.…”

Section: Vision Refraction and Motility Abnormalitiesmentioning

confidence: 99%

Guideline for Care of Patients With the Diagnoses of Craniosynostosis

Mathijssen¹

2015

Journal of Craniofacial Surgery

194

179

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Treatment of unilateral coronal synostosis by endoscopic strip craniectomy or fronto-orbital advancement: Ophthalmologic findings

Cited by 56 publications

References 20 publications

Early treatment of coronal synostosis with endoscopy-assisted craniectomy and postoperative cranial orthosis therapy: 16-year experience

Early treatment of coronal synostosis with endoscopy-assisted craniectomy and postoperative cranial orthosis therapy: 16-year experience

Rectus muscle excyclorotation and V-pattern strabismus: a quantitative appraisal of clinical relevance in syndromic craniosynostosis

Guideline for Care of Patients With the Diagnoses of Craniosynostosis

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