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[Cranial development after corrective skull surgery in craniosynostosis]
K W Grätz1, M C Locher, F R Carls
1Klinik und Poliklinik für Kiefer- und Gesichtschirurgie, Universitätsspital Zürich.
Insights
Surgical vault corrections for craniosynostosis do not impede calvaria growth. This study found no significant difference in skull growth potential between syndromic and non-syndromic craniosynostosis patients post-surgery.
Area of Science:
- Pediatric Surgery
- Craniofacial Surgery
- Developmental Biology
Context:
- Craniosynostosis involves premature fusion of skull sutures, impacting cranial development.
- Vault reconstruction is a common surgical intervention for craniosynostosis.
- Understanding the long-term effects on calvaria growth is crucial for patient outcomes.
Purpose:
- To prospectively evaluate the impact of vault correction surgery on calvaria growth in children with craniosynostosis.
- To correlate pre- and post-operative growth percentiles with normal growth standards.
- To compare growth outcomes between syndromic and non-syndromic craniosynostosis cases.
Summary:
- This prospective study analyzed 71 children undergoing craniosynostosis vault correction, with 57 followed for over 12 months.
- Measurements of fronto-occipital circumference were compared to Prader's percentile table.
- Results indicated no observed growth restriction of the reshaped calvaria, with similar growth potential in both syndromic and isolated craniosynostosis groups.
Impact:
- Surgical vault correction appears safe regarding calvaria growth, without significant restriction.
- The findings suggest that surgical intervention does not negatively alter the growth trajectory of the skull.
- This research provides valuable data for surgical planning and counseling in craniosynostosis management.
Abstract:
Craniofacial development may be potentially implicated after vault corrections in cases of craniosynostosis. The aim of this prospective study was the investigation of the surgical effect on calvaria growth, correlating the percentiles of a group of patients before and after craniosynostosis correction in relation to the normal percentiles of growth. The patient population consisted of 71 children; the postoperative follow-up time in 57 patients was more than 12 months. Of the children followed up, 36 were male and 21 female. Thirty-six cases involved untreated non-syndromic craniosynostosis; the remaining 21 were syndrome cases. The patient ages ranged from 16 to 27 months. In 11 cases correction of an occipital craniosynostosis was carried out. The fronto-occipital circumference was registered in accordance with Prader's percentile table. The operative method included a fronto-parietal craniotomy, the temporary removal and shaping of the fronto-orbital band and a vault cranioplasty. During follow-up 13 patients treated with fronto-orbital advancement in cases of isolated craniosynostosis remained in the registered percentile curve. In 13 patients a change to a lower percentile curve was confirmed; 1 patient changed to a higher curve. In cases of syndromic craniosynostosis 10 patients remained in the post-operatively registered percentile curve; 8 patients changed to a lower and 1 patient to a higher percentile curve. No growth restriction of the reshaped calvaria after surgical correction of craniosynostosis was observed. No significant difference was found in the potential calvaria growth between syndromic and isolated craniosynostosis.