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Correction of Sagittal Craniosynostosis Using Distraction Osteogenesis Based on Strategic Categorization
Myung Chul Lee1,2, Kyu Won Shim1,2, In Sik Yun1,2
1Seoul, Republic of Korea.
Plastic and Reconstructive Surgery
|December 28, 2016
Summary
Distraction osteogenesis effectively corrects sagittal synostosis. This study analyzed three procedures, showing improved cranial index and neurodevelopmental outcomes, particularly in group 3.
Area of Science:
- Craniofacial surgery
- Pediatric neurosurgery
- Orthognathic surgery
Background:
- Sagittal synostosis, a condition causing premature fusion of the skull's sagittal suture, necessitates surgical intervention.
- Distraction osteogenesis offers a reconstructive approach for craniosynostosis, with varied procedural techniques.
- Objective measurements are crucial for evaluating the efficacy of distraction osteogenesis in treating sagittal synostosis.
Purpose of the Study:
- To introduce and evaluate three distinct distraction osteogenesis procedures for sagittal synostosis.
- To compare the outcomes of different distraction techniques using objective measurements.
- To assess the impact of these procedures on cranial morphology and neurodevelopment.
Main Methods:
- Fifty-four patients with sagittal synostosis were divided into three groups based on distraction osteogenesis techniques.
- Procedures included anteroposterior compression with bitemporal expansion, bitemporal expansion alone, and anteroposterior expansion with bitemporal expansion.
- Key outcome measures analyzed were cranial index, head circumference, intracranial volume, and neurodevelopmental index (Bayley Scales of Infant Development II).
Main Results:
- Preoperative cranial indices varied significantly between groups, but all converged to a normal range postoperatively.
- Intracranial volume, initially low in 80% of group 3 patients, normalized in 90% after surgery.
- Significant improvements in mental and psychomotor developmental indices were observed postoperatively, especially in groups 1 and 3.
Conclusions:
- Distraction osteogenesis is an effective treatment for symmetric sagittal synostosis.
- Strategic categorization of distraction osteogenesis procedures enhances treatment outcomes.
- The study highlights the benefits of distraction osteogenesis in improving both cranial shape and neurodevelopmental status.