Background: Premature fusion of cranial sutures affects skull development. Intracranial pressure increase and brain growth restriction can occur in untreated craniosynostosis. Operative treatment aims to restore skull function and aesthetics. This study was designed to evaluate the effect of a total calvarial reconstruction on skull development in patients with nonsyndromic sagittal synostosis.
Material and Methods: The study population included 19 male and 5 female patients with isolated nonsyndromic sagittal suture synostosis. Preoperative and postoperative intracranial volumes were measured on CT data sets as criteria for the intended volume increase after surgery and in the follow-up. Cephalic indices were extracted from CT data to evaluate the length and width relation as aesthetic criteria.
Results: The male population presented with a preoperative mean ICV of 863.3 cm³. A postoperative mean ICV increase of 243.5 cm³ (p < 0.001) and a further ICV enlargement (p < 0.001) was measured. The mean CI changed from 71.0 % preoperatively to 75.4 % postoperatively (p = 0.002) and decreased insignificantly in the follow-up (p = 0.546). The female population had a preoperative mean ICV of 804.9 cm³. Postoperatively, the mean ICV increased by 211.1 cm³ (p = 0.043) and also increased in the follow-up (p = 0.043). Their mean CI values increased from 66.5 % preoperatively to 72.8 % (p = 0.043) postoperatively and decreased insignificantly in the follow-up (p = 0.345).
Conclusion: This method of total vault remodelling provides reliable intracranial volume increase and improvement in length and width skull proportions beyond the immediate postoperative period.