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Changes in Ventricular Volume After Posterior Vault Distraction Osteogenesis in Patients With Syndromic and

Matthew E Pontell1, Carlos E Barrero1, Kirin Naidu2

  • 1Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia.

The Journal of Craniofacial Surgery
|August 28, 2024
PubMed

Insights

Posterior vault distraction osteogenesis significantly increased intracranial volume in craniosynostosis patients. Nonsyndromic craniosynostosis patients showed significant ventricular volume changes, suggesting a compensated state potentially linked to intracranial pressure regulation.

Area of Science:

  • Neurosurgery
  • Pediatric Plastic Surgery
  • Craniofacial Surgery

Background:

  • Cranial vault surgery's impact on the ventricular system in craniosynostosis remains unclear.
  • Posterior vault distraction osteogenesis (PVDO) is a surgical technique used to treat craniosynostosis.

Purpose of the Study:

  • To evaluate changes in the cerebral ventricular system following PVDO.
  • To compare ventricular system response in syndromic versus nonsyndromic craniosynostosis.

Main Methods:

  • Retrospective review of craniosynostosis patients undergoing PVDO (2000-2022).
  • Analysis of pre- and postoperative cranial CT scans.
  • Calculation of ventricular volume (VV) and intracranial volume (ICV) using segmentation software.

Main Results:

  • Both syndromic and nonsyndromic groups showed increased ICV post-PVDO.
  • Only nonsyndromic synostosis (NSS) patients exhibited significant VV changes (P=0.004).
  • Normalized VV (total, lateral, third) increased significantly in NSS patients (114%, 117%, 89% respectively).

Conclusions:

  • Intracranial environments differ between syndromic and nonsyndromic craniosynostosis.
  • NSS patients may maintain parenchymal health via reduced VV, preventing intracranial hypertension.
  • VV may serve as a surrogate marker for intracranial pressure elevation.
Abstract

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