Effect of Presurgical Positioning on Skull Shape in Sagittal Suture Synostosis

Veelen, Marie-Lise C. van; Bredero, Hansje H.; Dirven, Clemens M.F.; Mathijssen, Irene M.J.

doi:10.1097/scs.0000000000002021

Cited by 7 publications

(2 citation statements)

References 23 publications

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“…In our experience, manuscripts that paired helmet therapy with surgical intervention did not demonstrate any long-term, significant differences in the postoperative CI or cephalic morphology attributable to orthotics. 20,43,50,54,59 The findings reiterate that the use of a helmet is not mandatory. In addition, major questions about its benefit remain unresolved.…”

Section: Discussionmentioning

confidence: 83%

“…Helmet therapy and presurgical skull positioning have been discussed in several manuscripts as an adjacent treatment to surgery. While van Veleen et al 59 reported changes in preoperative head circumference after undergoing nonrestrictive skull positioning therapy, these results have not been correlated with postoperative outcomes. Helmet treatment was almost exclusively seen in the cohort 0 to 6 months of age (16 of 17 total articles) and in all but one study involving MIS techniques.…”

Section: Discussionmentioning

confidence: 95%

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Sagittal Craniosynostosis: Treatment and Outcomes According to Age at Intervention

Franco-Mesa,

Shah,

Konofaos

2023

Journal of Craniofacial Surgery

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The purpose of this study is to describe the treatment strategies and outcomes of nonsyndromic single-suture sagittal craniosynostosis based on the patient’s age at intervention. Studies from MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials were systematically searched for patients with nonsyndromic single-suture sagittal craniosynostosis. Inclusion criteria encompassed studies with follow-up of at least 12 months, minimum of 25 patients per cohort, and first-time surgical intervention. The risk of bias in nonrandomized studies of intervention tool [Risk Of Bias In Non-randomized Studies—of Interventions (ROBINS-I)] was applied. A total of 49 manuscripts with 3316 patients met criteria. Articles were categorized based on age at intervention; 0 to 6, older than 6 to 12, and older than 12 months. Fifteen of the manuscripts described interventions in more than 1 age group. From the 49 articles, 39 (n=2141) included patients 0 to 6 months old, 15 (n=669) discussed patients older than 6 to 12 months old, and 9 (n=506) evaluated patients older than 12 months old. Follow-up ranged from 12 to 144 months. Over 8 types of open surgical techniques were identified and 5 different minimally invasive procedures were described. Minimally invasive procedures were exclusively seen in the youngest patient cohort, while open cranial vault reconstructions were often seen in the 2 older cohorts. Endoscopic surgery and open conservative procedures are indicated for younger patients, while complex open cranial vault reconstructions are common in older patients. However, there is no consensus on one approach over the other. Even with the analysis of this review, we cannot factor a strong conclusion on a specific technique.

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