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Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
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313
Asymmetric Multisutural Craniosynostosis: an Algorithm of Early Intervention to Prevent Evolving Deformity
Michael R Bykowski1, Sanjay Naran, Renata Maricevich
1Department of Pediatric Plastic Surgery, Children's Hospital of Pittsburgh, Pittsburgh, PA.
The Journal of Craniofacial Surgery
|July 1, 2017
Summary
A staged surgical approach for asymmetric multisutural craniosynostosis (AMC) in infants leads to better outcomes. This method reduces complications like elevated intracranial pressure and developmental delays, improving both function and appearance.
Area of Science:
- Craniofacial Surgery
- Pediatric Neurosurgery
- Plastic Surgery
Background:
- Asymmetric multisutural craniosynostosis (AMC) involves premature fusion of cranial sutures, leading to complex deformities.
- AMC is rare, complex, and associated with high reoperation rates, necessitating evaluation of treatment strategies.
Purpose of the Study:
- To evaluate the outcomes of a staged surgical approach for treating asymmetric multisutural craniosynostosis (AMC).
Main Methods:
- Retrospective review of patients with AMC treated between 2004 and 2013 with a minimum 2-year follow-up.
- A 3-stage algorithm: extended strip craniectomy, postoperative helmet molding, and fronto-orbital advancement or revision.
- Evaluation of morphologic, aesthetic, and functional outcomes, comparing staged vs. traditional methods.
Main Results:
- Five patients treated with the staged approach (Group A) had earlier first procedures than four treated traditionally (Group B).
- No Group A patients experienced developmental delay, elevated intracranial pressure, or reoperation post-surgery.
- Sixty percent of Group A patients achieved Whitaker Classification II, and 40% achieved Classification III.
Conclusions:
- AMC presents a complex, evolving craniofacial deformity.
- A staged approach with early helmet therapy for AMC yields acceptable functional and aesthetic outcomes with fewer complications.
