Date: November 2017.
Source: Academic dissertation, Health and Biosciences, University of Oulu.
Abstract: This work evaluated the safety and effectiveness of operative techniques used in cranioplastic
surgery and outcomes of these surgical methods.
In study I the feasibility of endocranial fixation in frontal remodeling surgery for metopic and coronal synostosis was established. Good to excellent aesthetic results were seen in 96% of cases evaluated by a surgeon at the time of follow-up. Three patients out of 27 had complications requiring revisions. No mortality or permanent morbidity, nor complications related to endocranial placement of the plates were seen. Thus it was verified that placing resorbable material intracranially reduces the aesthetic impact without hindering the final result.
Study II found that posterior cranial vault distraction procedures produced a mean increase of 25% in intracranial volume. This proved to be an effective technique for treating a variety of craniosynostosis with significant shortage of intracranial volume. 3D photogrammetric imaging was found to be a suitable non-ionizing method for evaluation of cranial volume increase following distraction. In study III a new tool was developed and successfully used for the intraoperative guidance of distractor device placement to ensure congruent vectors and thus reduced complications of these surgical procedures.
In study IV long-term functional and aesthetic outcomes of the surgical treatment for sagittal synostoses in patients reaching adulthood was examined. The mean follow-up time was 26.5 years and the patients were 18 to 41 years old at the time of follow-up. The patients treated for sagittal synostosis were equally satisfied with their facial appearance as were their age and gender matched controls. Independent panels found patients’ appearance to be slightly less attractive, but the difference was less than 10 mm on a 100 mm Visual Analogue Scale, representing a low clinical significance. Patients’ socioeconomic situation such as education, housing, employment and marital status equaled controls with similar frequencies of headaches, mental problems or health issues as the controls.
Article: Treatment of craniosynostoses.
Authors: Salokorpi, Niina, University of Oulu Graduate School; University of Oulu, Faculty of Medicine; Medical Research Centre Oulu; Oulu University Hospital Acta Univ. Oul. D 1428, 2017, University of Oulu, P.O. Box 8000, FI-90014 University of Oulu, Finland.