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Surgical correction of sagittal craniosynostosis: complications of the pi procedure
1Division of Plastic Surgery, Department of Neurosurgery, Temple University School of Medicine, Philadelphia, PA, USA.
Insights
The pi procedure offers a safe and effective surgical correction for scaphocephaly in infants. This technique demonstrates limited complications, making it ideal for infants over three months old.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Sagittal craniosynostosis, a condition causing premature fusion of the skull's sagittal suture, requires surgical intervention.
- The pi procedure is a surgical technique used for correcting scaphocephaly.
Purpose of the Study:
- To evaluate the complications associated with the pi procedure in pediatric patients.
- To determine the efficacy and safety of the pi procedure for scaphocephaly correction.
Main Methods:
- Retrospective analysis of 45 children undergoing the pi procedure for scaphocephaly.
- Utilized a modified prone position with beanbag head support.
- Performed reverse procedures and frontal pulling osteotomies.
Main Results:
- Average patient age was 9.2 months.
- Mean blood loss was 96 ml/kg, with transfusions in 36 patients.
- Complications included three dural injuries; no air embolism detected. One postoperative seizure occurred.
Conclusions:
- The pi procedure is associated with limited complications, comparing favorably to alternative techniques.
- The pi procedure is considered the preferred surgical method for sagittal craniosynostosis in infants older than three months.
Abstract:
We have completed a retrospective analysis of our experience with the pi procedure to determine the complications of the technique. Forty-five children underwent correction of scaphocephaly during the last 4 years. The average patient age was 9.2 months. The modified prone position with beanbag head support was used in 40 of 45 patients. Accompanied by barrel-stave and radial osteotomies, the reverse procedure was performed in 18 patients and frontal pulling in 27 patients. The average anteroposterior skull reduction was 1.44 cm, and mean blood loss was 96 ml, 11 ml/kg, replaced in 36 patients. Complications included three dural injuries, and air embolism was not detected by Doppler or end-tidal monitoring. A single child had a postoperative seizure. We conclude that complications of the pi procedure are limited and compare favorably with other repair techniques. We consider the pi procedure the technique of choice for correction of sagittal craniosynostosis in patients older than 3 months.