The cognition of patients with sagittal synostosis and developmental or behavioral concerns in relation to surgical...

The cognitive outcome of patients with sagittal synostosis (SS) has been studied previously; however, patients with developmental or behavioral problems have often been excluded, resulting in an incomplete picture. In this retrospective study, the authors evaluate the cognitive profile of patients with both SS and developmental or behavioral problems, as well as its relationship with the type and timing of the surgery performed.

All patients born between 2000 and 2018 at a single institution who had a diagnosis of SS and underwent surgery were included in the study. Patients were treated with one of the following surgical techniques: spring-assisted correction, extended strip craniotomy, or frontobiparietal remodeling. Subsequently, if parents had concerns about their child's developmental or behavioral functioning, the child underwent psychological or psychiatric diagnostic assessment. The Wechsler Preschool and Primary Scale of Intelligence or the Wechsler Intelligence Scale for Children were used to evaluate cognitive profiles. Full Scale IQ (FSIQ), Verbal IQ (VIQ), Performance IQ (PIQ), and index scales were used to measure cognitive profiles.

Among the 534 patients with SS who presented to the outpatient clinic after surgery, 99 (18.5%) had parents who expressed concerns about their child's developmental or behavioral functioning. Seventy-eight patients (14.6%) underwent psychological or psychiatric assessment. The mean FSIQ, VIQ, and PIQ scores were 96.29 ± 13.66, 98.21 ± 14.51, and 96.10 ± 12.98, respectively; both the mean FSIQ and PIQ were lower than the norm (p = 0.02). Patients with SS had lower Visual Spatial Index scores than the norm (91.82 ± 16.80, p = 0.005). The type and timing of surgery were not related to the cognitive profile of patients with SS. Results were adjusted for sex, age at surgery, and parental education level.

Of the 534 patients with SS, 99 had parents who voiced concerns about their child's development or behavior. The intellectual ability of patients with both SS and developmental or behavioral issues was slightly lower than the norm. Surgical technique and timing did not affect the cognitive profile.