Early surgical treatment of nonsyndromic craniosynostosis

Ferreira, Marcelo Paglioli; Collares, Marcus Vinícius Martins; Ferreira, Nelson Pires; Kraemer, Jorge Luiz; Filho, Arthur de Azambuja Pereira; Filho, Gustavo de Azambuja Pereira

doi:10.1016/j.surneu.2005.11.038

Cited by 23 publications

(28 citation statements)

References 27 publications

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“…Nevertheless, some problems regarding treatment of craniosynostosis still remain unanswered 6,22,30,37 . Although some reports have addressed the global results of craniosynostosis management 16,17,41 , most of them are from the last decade of the 20 th century 29,30,41 and, in our opinion, they are not sufficient to establish a universal accepted algorithm of treatment. The scarcity of available publications dealing with complications is also surprising.…”

Section: Introductionmentioning

confidence: 92%

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Surgical treatment of isolated and syndromic craniosynostosis. Results and complications in 283 consecutive cases

et al. 2008

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SummaryObjective. To review the results and complications of the surgical treatment of craniosynostosis in 283 consecutive patients treated between 1999 and 2007.Patients and methods. Our series consisted of 330 procedures performed in 283 patients diagnosed with scaphocephaly (n=155), trigonocephaly (n=50), anterior plagiocephaly (n=28), occipital plagiocephaly (n=1), non-syndromic multi-suture synostosis (n=20), and with diverse craniofacial syndromes (n=32; 11 Crouzon, 11 Apert, 7 Pfeiffer, 2 Saethre-Chotzen, and 2 clover-leaf skull). We used the classification of Whitaker et al. to evaluate the surgical results. Complications of each technique and time of patients' hospitalization were also recorded. The surgeries were classified in 12 different types according to the techniques used. Type I comprised endoscopic assisted osteotomies for sagittal synostosis (42 cases). Type II included sagittal suturectomy and expanding osteotomies (46 cases). Type III encompassed procedures similar to type II but that included frontal dismantling or frontal osteotomies in scaphocephaly (59 cases). Type IV referred to complete cranial vault remodelling (holocranial dismantling) in scaphocephaly (13 cases). Type V belonged to fronto-orbital remodelling without fronto-orbital bandeau in trigonocephaly (50 cases). Type VI included fronto-orbital remodelling without fronto-orbital bandeau in plagiocephaly (14 cases). In Type VII cases of plagiocephaly with frontoorbital remodelling and fronto-orbital bandeau were comprised (14 cases). Type VIII consisted of occipital advancement in posterior plagiocephaly (1 case). Type IX included standard bilateral fronto-orbital advancement with expanding osteotomies (30 cases). Type X was used in multi-suture craniosynostosis (15 cases) and consisted of holocranial dismantling (complete cranial vault remodelling). Type XI included occipital and suboccipital craniectomies in multiple suture craniosynostosis (10 cases) and Type XII instances of fronto-orbital distraction (26 cases).Results. The mortality rate of the series was 2 out of 283 cases (0.7%). These 2 patients died one year after surgery. All complications were resolved without permanent deficit. Mean age at surgery was 6.75 months. According to Whitaker et al's classification, 191 patients were classified into Category I (67.49%), 51 into Category II (18.02%), 30 into Category III (10.6%) and 14 into Category IV (4.90%). Regarding to craniofacial conformation, 85.5 % of patients were considered as a good result and 15.5% of patients as a poor result. Of the patients with poor results, 6.36% were craniofacial syndromes, 2.12% had anterior plagiocephaly and 1.76% belonged to non-syndromic craniosynostosis.The most frequent complication was postoperative hyperthermia of undetermined origin (13.43% of the cases), followed by infection (7.5%), subcutaneous haematoma (5.3%), dural tears (5%), and CSF leakage (2.5%). The number of complications was higher in the group of re-operated patients (12.8% of all). In this subset of reoperations, i...

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Section: Introductionmentioning

confidence: 92%

“…The scarcity of available publications dealing with complications is also surprising. In addition, most of them are included in clinical series regarding general aspects of the craniosynostoses 16,41,[44][45][46] or dealing with postoperative infection 13,25,48 .…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of isolated and syndromic craniosynostosis. Results and complications in 283 consecutive cases

et al. 2008

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“…At that time mostly simple craniectomy was performed. Simple craniectomy was unfortunately accompanied by a high rate of reossification and gave only modest results, unless mobilization of the orbits, midface, and cranium was performed concurrently (34). Today there are many surgical techniques and modifications that have been described for skull reconstruction in craniosynostosis.…”

Section: Review Of Diagnostical Methods and Discussionmentioning

confidence: 99%

Diagnosis and treatment of craniosynostosis: Vilnius team experience

Zaleckas¹,

Neverauskienė²,

Daugelavičius³

et al. 2015

AML

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Background. The aim of the study was to review the methods of diagnosis of craniosynostosis and to analyze Vilnius (Lithuania) team experience of surgical treatment, surgical methods, aspects of anesthesia for patients with craniosynostosis and to present early results of surgical treatment.Materials and methods. A retrospective review of all patients with various types of craniosynostosis treated surgically during the period from 1 January 2009 to 31 December 2014 was performed. The following data were analyzed: age, type of deformity, surgical technique, surgical time, methods and course of anesthesia, intra-and postoperative complications, parents' satisfaction, head form.Results. 24 patients were treated. The mean patient's age at the time of surgery was 13.47 ± 8.2 months (min 7.3, max 46.5). Eliminating 3 patients whose age at the time of surgery was over 2 years (24.5, 29 and 46 months, respectively), the mean age of other 21 patients was 10.63 ± 1.77 (min 7.3, max 14.1) months. There were 9 cases of isolated trigonocephaly (37.5%), 7 cases of isolated scaphocephaly (29.2%), 7 cases of isolated anterior plagiocephaly (29.2%) and 1 case of posterior plagiocephaly combined with scaphocephaly (4.17%). All craniosynostoses were diagnosed clinically and diagnosis was confirmed with computed tomographic scanning. The median duration of surgery was 336.47 ± 59.63 minutes (min 308.13, max 364.82). The medium stay in the intensive care unit was 2.53 ± 1.28 days (min. 1.92, max 3.14). In all cases rigid osteosynthesis was performed. 2 children were diagnosed with syndromic craniofacial abnormalities. In 23 (95.83%) cases an intraoperative or postoperative blood transfusion was required. In 24 treated patients there was no mortality. During the early and late postoperative period no infections, CSF leakage and dural tears were observed. No neurological impairments or any signs of neurological deficits were observed by any of the treated patients. In all of cases parents were satisfied with their children's changed head shape and aesthetic results.Conclusions. Cranioplasties for correction of craniosynostosis give good aesthetic results and this is a safe method, which helps to correct the head shape as well as improves the social adaptation of patients.

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“…Many papers have shown that the optimal age period for surgical correction of scaphocephaly is between birth and 12 months of age [3][4][5][6]9,11,18,[23][24][25]27,29) . As the skull grows, the degree of stiffness increases markedly with age due to an increase in the thickness of the two tables of skull 11,21,25) .…”

Section: Optimal Timing Of Surgical Correctionmentioning

confidence: 99%

“…In this paper, the authors describe a surgical technique for immediate spon- Preoperative Postoperative plinary approach can minimize the risk of morbidity and mortality in the treatment of craniosynostosis, thereby leading to a satisfactory outcome 9) . And, it is also important to understand the psychomotor development of the patient as well as the natural course of skull growth prior to conducting surgery to correct skull shape.…”

Section: Concepts and Advantages Of Expantile Zigzag Craniectomymentioning

confidence: 99%

Immediate Spontaneous Shape Correction Using Expantile Zigzag Craniectomy in Infantile Scaphocephaly -Is There an Improvement in the Developmental Quotient Following Surgery?-

Kim

2011

J Korean Neurosurg Soc

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Early surgical treatment of nonsyndromic craniosynostosis

Cited by 23 publications

References 27 publications

Surgical treatment of isolated and syndromic craniosynostosis. Results and complications in 283 consecutive cases

Surgical treatment of isolated and syndromic craniosynostosis. Results and complications in 283 consecutive cases

Diagnosis and treatment of craniosynostosis: Vilnius team experience

Immediate Spontaneous Shape Correction Using Expantile Zigzag Craniectomy in Infantile Scaphocephaly -Is There an Improvement in the Developmental Quotient Following Surgery?-

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