Related Experiment Video
Updated: Jul 4, 2025
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
[Prospective analysis of inflammatory markers and perioperative clinical data in children with craniosynostosis
B A Bashiryan1, O A Gadzhieva1, L A Satanin1
1Burdenko Neurosurgical Center, Moscow, Russia.
Insights
Reconstructive surgery for craniosynostosis (CS) in children causes a significant, non-infectious inflammatory response. Serum presepsin helps differentiate infection from normal healing post-CS surgery.
Area of Science:
- Pediatric Surgery
- Craniofacial Surgery
- Inflammation Markers
Context:
- Craniosynostosis (CS) involves premature closure of cranial sutures, often requiring reconstructive surgery in infants.
- The surgical stress response and inflammatory markers post-CS surgery in children remain incompletely understood.
- Evaluating clinical and laboratory parameters is crucial for managing pediatric CS patients.
Purpose:
- To assess clinical and laboratory parameters in pediatric patients undergoing reconstructive surgery for craniosynostosis (CS).
- To investigate the systemic inflammatory response following traumatic reconstructive surgery for CS in children.
- To determine the utility of specific inflammatory markers in differentiating infectious complications from a normal postoperative course.
Summary:
- The study analyzed 32 children under 24 months with CS who underwent reconstructive surgery.
- Postoperative inflammatory markers, including C-reactive protein, procalcitonin, and ferritin, significantly increased, indicating a nonspecific systemic reaction.
- No infectious complications were observed; serum presepsin proved useful in distinguishing infection from uncomplicated recovery.
Impact:
- Findings clarify the expected inflammatory response after CS reconstructive surgery in children, distinguishing it from infection.
- Highlights the highly traumatic nature of CS reconstructive procedures.
- Establishes serum presepsin as a valuable tool for differential diagnosis in the early postoperative period for pediatric CS patients.
Background:
Craniosynostosis (CS) is a group of skull malformations manifested by congenital absence or premature closure of cranial sutures. Reconstructive surgery in the second half of life is traditional approach for CS. The issues of surgical stress response after reconstructive surgery for CS in children are still unclear.
Objective:
To evaluate clinical and laboratory parameters in children undergoing traumatic reconstructive surgery for CS.
Material And Methods:
Inclusion criteria were CS, reconstructive surgery, age <24 months, no comorbidities and available laboratory diagnostic protocol including complete blood count, biochemical blood test with analysis of C-reactive protein, procalcitonin, ferritin and presepsin. The study included 32 patients (24 (75%) boys and 8 (25%) girls) aged 10.29±4.99 months after surgery between October 2021 and June 2022. Non-syndromic and syndromic forms of CS were observed in 25 (78.1%) and 7 (21.9%) cases, respectively.
Results:
There were no infectious complications. We analyzed postoperative clinical data, fever, clinical and biochemical markers of inflammation.
Conclusion:
Early postoperative period after reconstructive surgery for CS in children is accompanied by significant increase of inflammatory markers (C-reactive protein, procalcitonin, ferritin). However, these findings do not indicate infectious complications. This is a manifestation of nonspecific systemic reaction. Severity of systemic inflammatory response syndrome with increase in acute phase proteins indicates highly traumatic reconstructive surgery for CS in children. Analysis of serum presepsin allows for differential diagnosis between infectious complication and uncomplicated course of early postoperative period.
