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Surgical correction for unilateral lambdoid synostosis: a systematic review
1From the Department of Craniofacial Surgery, Imperial College London, Chelsea and Westminster Hospital, London, England.
The Journal of Craniofacial Surgery
|July 1, 2014
Summary
Unilateral lambdoid synostosis diagnosis is often confused with deformational plagiocephaly. This review of true cases shows surgery is safe, with improved neurodevelopment, but facial asymmetry may persist.
Area of Science:
- Craniofacial Surgery
- Pediatric Neurosurgery
- Developmental Biology
Background:
- Unilateral lambdoid synostosis, a rare craniosynostosis, was historically misdiagnosed due to non-specific criteria.
- This diagnostic ambiguity led to confusion regarding its features and surgical management in the late 20th century.
Purpose of the Study:
- To systematically review literature for genuine cases of unilateral lambdoid synostosis.
- To analyze the outcomes of surgical corrections for this condition.
Main Methods:
- Systematic review utilizing a defined search strategy on MEDLINE and Google Scholar.
- Included search terms: Unilateral, lambdoid synostosis/craniosynostosis, posterior plagiocephaly, and surgery.
- Data from 17 studies involving 188 patients were compiled and analyzed.
Main Results:
- No major surgical complications were reported.
- Facial asymmetry and auricular displacement showed limited improvement post-surgery.
- Neurodevelopment remained stable or improved; endoscopic techniques offered shorter hospital stays and reduced blood loss.
- Optimal surgical timing identified as 6-12 months for neurodevelopment and cranial morphology.
Conclusions:
- Accurate diagnosis is crucial, as deformational plagiocephaly is often misidentified as unilateral lambdoid synostosis.
- This review consolidates evidence on true unilateral lambdoid synostosis cases and surgical outcomes.
- Further long-term quantitative studies are needed to evaluate surgical procedure efficacy.
