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Coronal and lambdoid suture evolution following total vault remodeling for scaphocephaly
Pierre-Aurélien Beuriat1,2,3, Alexandru Szathmari1,2, Julie Chauvel-Picard1,4,3
11French Referral Center for Craniosynostosis.
Neurosurgical Focus
|April 1, 2021
Summary
Neosuture formation is common after surgical correction for sagittal craniosynostosis, even when coronal and lambdoid sutures are removed. This study reveals varied outcomes and suggests potential differences among cranial sutures.
Area of Science:
- Craniofacial Surgery
- Pediatric Neurosurgery
- Developmental Biology
Background:
- Craniosynostosis treatment often involves removing fused sutures.
- Limited data exists on suture evolution post-craniosynostosis surgery, especially after total cranial vault remodeling.
- Neosuture formation after removing patent sutures is not well-documented.
Purpose of the Study:
- To investigate cranial bone evolution after removing coronal and lambdoid sutures during total vault remodeling for sagittal craniosynostosis.
- To determine the possibility and patterns of neosuture formation in these patients.
Main Methods:
- Retrospective review of CT scans from children treated for scaphocephaly (sagittal synostosis) between 2004-2014.
- Inclusion criteria: isolated sagittal synostosis, age 4-18 months at surgery, postoperative CT at least 1 year post-op.
- Analysis of 37 patients (26 boys, 11 girls) with a mean follow-up of 5.3 years.
Main Results:
- Neosutures were detected on 3D CT reconstructions despite the removal of coronal and lambdoid sutures.
- Various neosuture formations observed: both coronal and lambdoid (n=20), lambdoid with frontoparietal fusion (n=12), frontoparietal with parietooccipital fusion (n=3), and coronal with parietooccipital fusion (n=2).
Conclusions:
- This is the first study to document skull response after removing patent sutures in total vault remodeling for sagittal synostosis.
- Neosuture reappearance is common, with incidence varying by suture type.
- Observed differences in neosuture formation suggest potential genetic and functional variations among cranial sutures.
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