Document Detail


Single sutural craniosynostoses: surgical outcomes and long-term growth.
MedLine Citation:
PMID:  19182624     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study was designed to examine long-term skull growth following single sutural synostosis corrections and to evaluate surgical outcomes.
METHODS: A retrospective outcome assessment of all children treated with a single-stage, open-remodeling procedure for sagittal, metopic, unilateral coronal, and unilateral lambdoid synostosis was performed. Long-term growth was assessed from serial anthropometric measurements taken up to 11 years postoperatively (mean, 4 years).
RESULTS: Of 296 consecutive patients, complete records were available for 248 operative procedures. The mean surgical age was 12.3 months (range, 2.5 months to 8 years), with 36 patients older than 12 months. Transfusion rates decreased from 81 to 19 percent following the institution of blood conservation strategies. The average hospitalization was 2.5 days. There was one nonsurgically treated infection (0.4 percent), and no major complications or deaths. Five patients underwent secondary remodeling procedures (2 percent). Serial anthropometric measurements, obtained in 75 patients, showed normalization of cranial indices 6 weeks postoperatively, but subsequent measurements revealed statistically significant diminished growth. Earlier surgical treatment of metopic synostosis (4 months) was associated with significantly more growth inhibition than seen in those treated at an older age (12 months), with the other synostoses showing similar tendencies.
CONCLUSIONS: Treatment of single sutural synostosis was extremely safe with very low reoperative rates, but subsequent calvarial growth was abnormal, with a tendency toward recapitulation of the primary deformity. Growth was less diminished in procedures performed in older infants. Surgeons treating single sutural craniosynostosis should consider expanding treatment goals beyond normalization to an overcorrection of the abnormal skull shape.
Authors:
Jeffrey A Fearon; Rachel A Ruotolo; John C Kolar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  123     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-02     Completed Date:  2009-03-02     Revised Date:  2011-02-16    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  635-42     Citation Subset:  AIM; IM    
Affiliation:
Craniofacial Center, Medical City Children's Hospital, Island Cleft and Craniofacial Center, Dallas, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Cephalometry*
Child
Child, Preschool
Cranial Sutures / growth & development*,  surgery*
Craniosynostoses / surgery*
Follow-Up Studies
Head / growth & development
Humans
Infant
Reconstructive Surgical Procedures*
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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