頭蓋骨癒合症手術における術者および保護者による転帰評価

While previous studies have focused on quantitative assessments and surgeon-reported surgical outcomes, limited research exists on parent-reported outcomes following surgical correction of craniosynostosis. Our study assessed both surgeon-assessed and parent-reported outcomes in children who underwent craniosynostosis correction surgery. A retrospective observational study analyzed the outcomes of 103 children who underwent craniosynostosis surgery between January 2009 and June 2022. First the surgeon assessed the outcome using the Sloan outcome classification system, which ranks cosmetic results on a six-point ordinal scale ranging from excellent correction (Class 1) to compromised correction requiring revision surgery (Class 7). Second, a non-structured patient-reported outcome measurement (PROM) evaluating subjective postoperative changes in cosmetic appearance, vision, oropharyngeal symptoms, scholastic performance, and quality of life (QOL) for both the child and parent was carried out. PROM responses were categorized as A (worsened), B (unchanged), C (moderately improved), or D (significantly improved). Fifty-eight children (56.3 %) achieved a Sloan Class 1 outcome, indicating excellent correction with no visible or palpable deformity. Children with metopic suture synostosis showed the highest improvement (85.7 %). Subjective outcome assessment using PROM revealed statistically significant differences between syndromic (S) and nonsyndromic (NS) craniosynostosis groups across multiple domains. There was a strong correlation between surgeon-reported outcomes and PROM domains of cosmesis, as well as parent and child quality of life. Our study highlights the importance of incorporating both objective and subjective measures in assessing outcomes of craniosynostosis surgery.