Springs Produce Favorable Morphologic Outcomes Relative to H-Craniectomy According to a Two-Center Comparison of Matched Cases.
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
01 Aug 2024
01 Aug 2024
Historique:
medline:
26
7
2024
pubmed:
26
7
2024
entrez:
24
7
2024
Statut:
ppublish
Résumé
Sagittal synostosis is the most common type of premature suture closure, and many surgical techniques are used to correct scaphocephalic skull shape. Given the rarity of direct comparisons of different surgical techniques for correcting craniosynostosis, this study compared outcomes of craniotomy combined with springs and H-craniectomy for nonsyndromic sagittal synostosis. Comparisons were performed using available preoperative and postoperative imaging and follow-up data from the 2 craniofacial national referral centers in Sweden, which perform 2 different surgical techniques: craniotomy combined with springs and H-craniectomy (the Renier technique). The study included 23 pairs of patients matched for sex, preoperative cephalic index, and age. Cephalic index, total intracranial volume (ICV), and partial ICV were measured before surgery and at 3 years of age, with volume measurements compared against those of preoperative and postoperative controls. Perioperative data included operation time, blood loss, volume of transfused blood, and length of hospital stay. Craniotomy combined with springs resulted in less bleeding and lower transfusion rates than H-craniectomy. Although the spring technique requires 2 operations, the mean total operation time was similar for the methods. Of the 3 complications that occurred in the group treated with springs, 2 were spring-related. The compiled analysis of changes in cephalic index and partial volume distribution revealed that craniotomy combined with springs resulted in superior morphologic correction. The findings showed that craniotomy combined with springs normalized cranial morphology to a greater extent than H-craniectomy based on changes in cephalic index and total and partial ICVs over time. Therapeutic, III.
Sections du résumé
BACKGROUND
BACKGROUND
Sagittal synostosis is the most common type of premature suture closure, and many surgical techniques are used to correct scaphocephalic skull shape. Given the rarity of direct comparisons of different surgical techniques for correcting craniosynostosis, this study compared outcomes of craniotomy combined with springs and H-craniectomy for nonsyndromic sagittal synostosis.
METHODS
METHODS
Comparisons were performed using available preoperative and postoperative imaging and follow-up data from the 2 craniofacial national referral centers in Sweden, which perform 2 different surgical techniques: craniotomy combined with springs and H-craniectomy (the Renier technique). The study included 23 pairs of patients matched for sex, preoperative cephalic index, and age. Cephalic index, total intracranial volume (ICV), and partial ICV were measured before surgery and at 3 years of age, with volume measurements compared against those of preoperative and postoperative controls. Perioperative data included operation time, blood loss, volume of transfused blood, and length of hospital stay.
RESULTS
RESULTS
Craniotomy combined with springs resulted in less bleeding and lower transfusion rates than H-craniectomy. Although the spring technique requires 2 operations, the mean total operation time was similar for the methods. Of the 3 complications that occurred in the group treated with springs, 2 were spring-related. The compiled analysis of changes in cephalic index and partial volume distribution revealed that craniotomy combined with springs resulted in superior morphologic correction.
CONCLUSION
CONCLUSIONS
The findings showed that craniotomy combined with springs normalized cranial morphology to a greater extent than H-craniectomy based on changes in cephalic index and total and partial ICVs over time.
CLINICAL QUESTION/LEVEL OF EVIDENCE
METHODS
Therapeutic, III.
Identifiants
pubmed: 39046901
doi: 10.1097/PRS.0000000000010761
pii: 00006534-202408000-00030
doi:
Types de publication
Journal Article
Multicenter Study
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
317e-325eInformations de copyright
Copyright © 2023 by the American Society of Plastic Surgeons.
Références
Socialstyrelsen. Kraniofacial kirurgi. Updated May 10, 2021. https://www.socialstyrelsen.se/arlig-uppfoljning-nationell-hogspecialiserad-vard/tillstandsomrade/viss-kraniofacial-kirurgi . Accessed November 11, 2020.
Lauritzen C, Sugawara Y, Kocabalkan O, Olsson R. Spring mediated dynamic craniofacial reshaping: case report. Scand J Plast Reconstr Surg Hand Surg. 1998;32:331–338.
Lauritzen CG, Davis C, Ivarsson A, Sanger C, Hewitt TD. The evolving role of springs in craniofacial surgery: the first 100 clinical cases. Plast Reconstr Surg. 2008;121:545–554.
Paganini A, Bhatti-Söfteland M, Fischer S, et al. In search of a singlestandardizedd system for reporting complications in craniofacial surgery: a comparison of three different classifications. J Plast Surg Hand Surg. 2019;53:321–327.
Boulos PT, Lin KY, Jane JA Jr, Jane JA Sr. Correction of sagittal synostosis using a modified pi method. Clin Plast Surg. 2004;31:489–498, vii.
Fischer S, Maltese G, Tarnow P, Wikberg E, Bernhardt P, Kölby L. Comparison of intracranial volume and cephalic index after correction of sagittal synostosis with spring-assisted surgery or pi-plasty. J Craniofac Surg. 2016;27:410–413.
Di Rocco F, Knoll BI, Arnaud E, et al. Scaphocephaly correction with retrocoronal and prelambdoid craniotomies (Renier’s “H” technique). Childs Nerv Syst. 2012;28:1327–1332.
Antunez S, Arnaud E, Cruz A, Marchac D, Renier D. Scaphocephaly: part I: indices for scaphocephalic frontal and occipital morphology evaluation: long-term results. J Craniofac Surg. 2009;20:1837–1842.
Maltese G, Fischer S, Strandell A, Tarnow P, Kölby L. Spring-assisted surgery in the treatment of sagittal synostosis: a systematic review. J Plast Surg Hand Surg. 2015;49:177–182.
Wikberg E, Bernhardt P, Maltese G, Tarnow P, Lagerlöf JH, Kölby L. A new computer tool for systematic evaluation of intracranial volume and its capacity to evaluate the result of the operation for metopic synostosis. J Plast Surg Hand Surg. 2012;46:393–398.
Unander-Scharin J, Nysjö J, Enblad P, Nowinski D. Secondary coronal synostosis after early surgery for sagittal craniosynostosis: implications for cranial growth. J Craniofac Surg. 2021;32:113–117.
Windh P, Davis C, Sanger C, Sahlin P, Lauritzen C. Spring-assisted cranioplasty vs pi-plasty for sagittal synostosis: a long term follow-up study. J Craniofac Surg. 2008;19:59–64.
Proctor MR, Meara JG. A review of the management of single-suture craniosynostosis, past, present, and future. J Neurosurg Pediatr. 2019;24:622–631.
van Veelen MC, Kamst N, Touw C, et al. Minimally invasive, spring-assisted correction of sagittal suture synostosis: technique, outcome, and complications in 83 cases. Plast Reconstr Surg. 2018;141:423–433.
Mathijssen IMJ; Working Group Guideline Craniosynostosis. Updated guideline on treatment and management of craniosynostosis. J Craniofac Surg. 2021;32:371–450.
Tahiri Y, Bartlett SP, Gilardino MS. Evidence-based medicine: nonsyndromic craniosynostosis. Plast Reconstr Surg. 2017;140:177e–191e.
Tatum SA, Jones LR, Cho M, Sandhu RS. Differential management of scaphocephaly. Laryngoscope 2012;122:246–253.
Al-Shaqsi SZ, Rai A, Forrest C, Phillips J. Standardization of cranial index measurement in sagittal craniosynostosis. J Craniofac Surg. 2019;30:366–369.
Calandrelli R, Pilato F, Massimi L, Panfili M, Di Rocco C, Colosimo C. The unseen third dimension: a novel approach for assessing head shape severity in infants with isolated sagittal synostosis. Childs Nerv Syst. 2019;35:1351–1356.
Dvoracek LA, Skolnick GB, Nguyen DC, et al. Comparison of traditional versus normative cephalic index in patients with sagittal synostosis: measure of scaphocephaly and postoperative outcome. Plast Reconstr Surg. 2015;136:541–548.
Ramamurthi A, Hallac RR, Chou PY, Kenyon L, Derderian CA. Three-dimensional treatment outcomes of a virtual helmet design protocol for sagittal strip craniectomy. Plast Reconstr Surg. 2021;147:436–443.
Arab K, Fischer S, Bahtti-Söfteland M, Maltese G, Kölby L, Tarnow P. Comparison between two different isolated craniosynostosis techniques: does it affect cranial bone growth? J Craniofac Surg. 2016;27:e454–e457.
Thwin M, Schultz TJ, Anderson PJ. Morphological, functional and neurological outcomes of craniectomy versus cranial vault remodeling for isolated nonsyndromic synostosis of the sagittal suture: a systematic review. JBI Database System Rev Implement Rep. 2015;13:309–368.