The management of sagittal synostosis using endoscopic suturectomy and postoperative helmet therapy

Ridgway, Emily B.; Berry-Candelario, John; Grondin, Ronald T.; Rogers, Gary F.; Proctor, Mark R.

doi:10.3171/2011.3.peds10418

Cited by 114 publications

(127 citation statements)

References 35 publications

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“…The initial postoperative CI of 75 or the 2-to 4-year postoperative CI of 73 was a good result, as compared with others. 2,4,6,12,15,18,22,23,[29][30][31][32]36,39,40,46,51 The decrease in CI that we observed over time is comparable to the limited available data on long-term outcome. 2,16 Adding a widening bridge complies with Fearon and colleagues' suggestion to overcorrect width to compensate for later growth restriction in that direction.…”

Section: Discussionsupporting

confidence: 70%

“…However, these techniques have better results with decreasing age at surgery, preferably around 3 months of age. 44,46 Not all patients are referred soon enough to undergo such early interventions; for those patients, late remodeling remains a reality. Furthermore, long-term results on minimally invasive procedures are scarce, and data on the incidence of elevated ICP and papilledema are lacking.…”

Section: Discussionmentioning

confidence: 99%

“…3,5,[9][10][11][12]15,17,[20][21][22][23][26][27][28][29][30][31][33][34][35][36]38,40,[43][44][45][46][47][48][49][50][51] The field continues to evolve and aims to reduce the impact of surgery. Minimally invasive approaches constitute the majority of recently detailed techniques.…”

mentioning

confidence: 99%

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Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome

Veelen¹,

Mihajlović²,

Dammers³

et al. 2015

PED

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OBJECT Various techniques to correct sagittal synostosis have been described. The authors of this study assess the results of 2 techniques for late complete cranial remodeling and test the hypothesis that adding a widening bridge would improve outcome. METHODS In this retrospective study, the authors evaluated patients with nonsyndromic sagittal synostosis—those who underwent frontobiparietal remodeling (FBR) and those who underwent modified FBR (MFBR) involving the introduction of a bony bridge to increase the width of the skull. Outcomes for both groups are described in terms of the aesthetic results assessed on photographs and any changes in the cranial index (CI) and head circumference over time, the presence of papilledema, and complaints of headache. The effect of the surgical technique on CI and head circumference over time was assessed using linear regression analysis, with adjustment for preoperative CI and head circumference. RESULTS Sixty-nine patients with isolated sagittal synostosis were included in this study: 35 underwent MFBR and 34 underwent the original technique of FBR. The mean follow-up period was 7 years. In the 1st year after surgery, mean CI improved by 9% in the FBR group and by 12% in the MFBR group. One year after surgery, CI in the MFBR group was on average 4.7% higher than that in the FBR group (p < 0.001). During follow-up, CI decreased in both groups; however, at all time points CI was significantly higher in the MFBR group than in the FBR group. The impact of surgical technique on CI was less important than the impact of preoperative CI (R2= 0.26 vs 0.54), and this applied at all time points during follow-up. Head circumference declined during follow-up in both groups. It was influenced by preoperative head circumference, but not by surgical technique. Aesthetic outcome, prevalence of headache (42%), and papilledema (7%) were comparable in both groups. CONCLUSIONS Adding a widening bridge to late complete remodeling significantly improved CI and helped to prevent CI from decreasing in the long term. This addition did not affect the head circumference growth curve. Despite a mean head circumference remaining at +1 SD, patients continued to develop papilledema postoperatively (7%).

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

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Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome

Veelen¹,

Mihajlović²,

Dammers³

et al. 2015

PED

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“…Nonsyndromic sagittal synostosis, leading to the clinical phenomenon known as scaphocephaly, is the most common variant and occurs in approximately 5 in 10,000 live births [11,15]. Endoscope-assisted suturectomy and post-operative helmet orthosis in newborns less than 3 months of age has become an increasingly widespread and favorable technique for surgical correction of single suture synostosis [2,4,5,[10][11][12]16]. This minimally invasive approach, compared to more traditional surgical techniques for craniosynostosis, such as cranial vault remodeling, relies on rapid brain growth of the newborn in addition to helmet therapy to slowly correct asymmetric head shape while allowing for decreased blood loss, anesthesia time, and hospital length of stay [7,13,14].…”

Section: Introductionmentioning

confidence: 99%

Single incision endoscope-assisted surgery for sagittal craniosynostosis

2016

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Objective The objective of this study is to present the novel technique and associated results of a single-incision endoscope-assisted procedure for the treatment of sagittal craniosynostosis. Methods We retrospectively reviewed the charts of infants who underwent single-incision endoscope-assisted sagittal craniectomy for craniosynostosis at our institution. Demographic data collected included patient age, blood loss, operative time, pre-and post-operative hemoglobin, pre-and post-operative cephalic index (CI), and hospital length of stay. Results Seven consecutive infants underwent surgery for sagittal craniosynostosis using a single-incision endoscopic technique. Average operative time was 87 (±10.5) minutes. Average blood loss was 32 (±13.5) cubic centimeters (cc). Post-operative hemoglobin was an average of 7.1 (±0.2) g/dL. No patients required a blood transfusion intra-operatively or in the post-operative setting. Dural tears were encountered in one patient. The average hospital length of stay was 1.4 (±1.1) days. Difference between pre-and post-operative CI was 8.4 % (±3.5; p < 0.05).Conclusions We demonstrate the novel use of a singleincision technique for endoscope-assisted sagittal craniosynostosis correction that improves upon the classically described surgical procedure by decreasing invasiveness, while allowing for excellent clinical outcomes.

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“…In our experience, sagittal synostosis is safely treated with endoscopic suturectomy and helmet therapy [7].…”

Section: Introductionmentioning

confidence: 99%

Potential therapeutic Strategies and Its Application in Correcting Birth Defects, Craniosynostosis, Neurological Disorders and Other Diseases

Barik¹

2013

J Metabolic Synd

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Background: Gene Therapy (GT) aims to fix a disease linked with genetic abnormality. Gene Therapy (GT) is currently receiving an attention from scientists, clinicians and the general public in an attempt to correct genetic defects. It including with congenital abnormalities, craniosynostosis (syndromic and nonsyndromic), craniofacial deformity, and neurodevelopmental disorders. However, its application is beset with complications partly because of lack of advanced knowledge, research and partly because of vested interest by the society.

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The management of sagittal synostosis using endoscopic suturectomy and postoperative helmet therapy

Cited by 114 publications

References 35 publications

Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome

Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome

Single incision endoscope-assisted surgery for sagittal craniosynostosis

Potential therapeutic Strategies and Its Application in Correcting Birth Defects, Craniosynostosis, Neurological Disorders and Other Diseases

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