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Syndromic vs Nonsyndromic Management of Multisuture Craniosynostosis: A Single-Center Experience
Roboan Guillen Arguello1,2, Somto Ngwudike2,3, Kathleen Hosek2
1Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans , Louisiana , USA.
Background And Objectives:
Multisuture craniosynostosis (CS) involves the fusion of 2 or more cranial sutures, and, rarely, fusion of most sutures results in pansynostosis. Patients with multisuture CS can be further subdivided into syndromic and nonsyndromic CS. The objective was to describe and analyze the incidence, management, and outcomes of syndromic and nonsyndromic multisuture CS patients at a single-center institution.
Methods:
Retrospective study of all multisuture CS pediatric patients who received care at a large tertiary hospital between September 2009 and August 2023. Demographic and clinical data, diagnoses, imaging studies, operative interventions, complications, and clinical follow-up were evaluated.
Results:
Seventy-five multisuture CS children were included. There were more male (n = 44) and Hispanic (n = 37) patients. The median number of surgeries was 2 [Q 1 -Q 3 : 1-2], and the average age at first cranial surgery was 11 [Q 1 -Q 3 : 3-29.75] months. The most common type of procedure was frontal-orbital advancement (n = 30), followed by open and endoscopic suturectomies (n = 28). There were 36 syndromic children (48%) and 39 nonsyndromic children (52%). Compared with nonsyndromic children, patients with syndromic multisuture CS had a higher median number of CS surgeries ( P = .0027) and differed in the types of sutures fused at the time of the index surgery ( P = .001). There was no statical significant difference between the incidence of craniocervical pathology in syndromic and nonsyndromic children (38.9% vs 23.1%; P = .137). One of 3 syndromic patients (33.3%) had a shunt placed ( P = .0148).
Conclusion:
The evaluation and treatment plan for multisuture CS is complex and requires multidisciplinary care. The authors described their experience and outcomes of syndromic and nonsyndromic multisuture CS children at a single high-volume institution. Syndromic children had a higher total median number of surgeries, were younger at index surgery, and had a higher incidence of shunt placement.
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