Postoperative cognitive outcome for synostotic frontal plagiocephaly
Irene Mathijssen1, Eric Arnaud, Elizabeth Lajeunie
1Craniofacial Malformations Unit, Department of Pediatric Neurosurgery, Hospital Necker- Enfants Malades, Paris, France.
Journal of Neurosurgery
|July 29, 2006
Summary
Early or late surgical correction for synostotic frontal plagiocephaly does not impact cognitive outcomes. While elevated intracranial pressure was noted in older surgical patients, intellectual development remained unaffected, suggesting cosmetic indications for surgery.
Area of Science:
- Pediatric Neurosurgery
- Craniofacial Surgery
- Developmental Pediatrics
Background:
- Synostotic frontal plagiocephaly involves premature fusion of cranial sutures, potentially affecting head shape and neurodevelopment.
- Surgical intervention aims to correct skull deformities and, historically, was thought to improve cognitive outcomes.
Purpose of the Study:
- To assess cognitive development following surgical correction of synostotic frontal plagiocephaly.
- To compare the impact of early (<1 year) versus late (≥1 year) surgical timing on intellectual development.
Main Methods:
- Prospective study of 220 patients with synostotic frontal plagiocephaly.
- Preoperative and postoperative cognitive function assessed using developmental quotient (DQ) or intelligence quotient (IQ).
- Intracranial pressure (ICP) and FGFR3 P250R mutation status were evaluated.
Main Results:
- No significant difference in postoperative IQ between early and late surgical groups.
- Preoperative cognitive function was not influenced by age at surgery.
- Elevated ICP occurred in 16% of late surgical patients, without cognitive impact.
- No correlation found between FGFR3 mutation and postoperative IQ.
Conclusions:
- Surgical timing for synostotic frontal plagiocephaly does not affect cognitive outcomes.
- Elevated ICP in older surgical patients did not correlate with impaired cognitive development.
- The primary indication for surgical correction appears to be cosmetic rather than cognitive enhancement.
