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Published on: June 20, 2018
Variations of endoscopic and open repair of metopic craniosynostosis
Sassan Keshavarzi1, Melanie G Hayden, Sharona Ben-Haim
1Department of Surgery, Division of Neurosurgery, Rady Children's Hospital and Health Care Center, University of California-San Diego, 200 W. Arbor Drive, San Diego, CA 92103-8893, USA. skeshavarzi@ucsd.edu
Insights
Endoscopic minimally invasive surgery and open fronto-orbital advancement are effective for metopic craniosynostosis. This study compares outcomes, offering insights into surgical technique selection for trigonocephaly treatment.
Area of Science:
- Craniofacial Surgery
- Pediatric Neurosurgery
- Plastic Surgery
Background:
- Metopic craniosynostosis, leading to trigonocephaly, requires surgical correction.
- The role of endoscopic techniques for metopic craniosynostosis is less defined than for sagittal craniosynostosis.
Purpose of the Study:
- To review clinical experience with endoscopic and open surgical techniques for metopic craniosynostosis.
- To compare outcomes between endoscopic and open fronto-orbital advancement in pediatric patients.
Main Methods:
- Retrospective review of 33 pediatric patients with metopic craniosynostosis treated over 5 years.
- Comparison of 16 patients undergoing endoscopic procedures versus 17 patients with open fronto-orbital advancement.
- Analysis of clinical parameters: age at surgery, blood loss, operative time, transfusion, hospital stay, complications, cranial banding, and reoperation rates.
Main Results:
- Detailed discussion of various endoscopic and open techniques employed.
- Evaluation of preliminary clinical outcomes for both surgical approaches.
- Analysis of factors influencing the selection of specific surgical techniques.
Conclusions:
- Both endoscopic and open surgical methods are utilized for metopic craniosynostosis treatment.
- The study provides preliminary insights into the clinical outcomes and technique selection for trigonocephaly correction.
Abstract:
In contrast to sagittal craniosynostosis, the role of endoscopic, minimally invasive approaches in the treatment of metopic craniosynostosis with resulting trigonocephaly is not as well defined. We reviewed the senior authors' (H.M. and S.C.) clinical experience in the treatment of children with metopic craniosynostosis using a variety of endoscopic and open techniques. Thirty-three patients were treated at a single institution during a 5-year period with between 3 and 8 years of follow-up. Sixteen patients underwent 3 variations of endoscopic approaches, and 17 patients had open fronto-orbital advancement. Clinical parameters of the 2 groups were examined including age at surgery, blood loss, operative time, transfusion volume, hospital stay, complications, use of postoperative cranial banding, and the need for reoperation for persistent deformity. The various endoscopic and open techniques used by the authors in the treatment of metopic craniosynostosis are discussed in detail, including rational for individual technique selection and preliminary impressions regarding clinical outcome.
