Date: June 2023.
Source: Journal of Neurosurgery: Pediatrics, 32(3), 277-284. https://doi.org/10.3171/2023.5.PEDS22528.
Objective: A literature gap exists comparing whole head shape outcome following correction of sagittal craniosynostosis. The objective of this multicenter study was to provide an analysis of long-term results following three different endoscopic strip craniectomy techniques for correction of sagittal craniosynostosis: 1) spring-assisted strip craniectomy, 2) wide-strip craniectomy with biparietal and bitemporal barrel-stave wedge osteotomies plus helmet orthosis, and 3) narrow-strip craniectomy plus orthosis without barrel staves.
Materials and Methods: Pre- and postoperative 3dMD stereo photogrammetric images were collected from patients who underwent craniosynostosis surgery. Procedures were divided among institutions as follows: spring-assisted strip craniectomies were performed at Atrium Health Wake Forest Baptist Hospital; narrow-strip craniectomies were performed at St. Louis Children’s Hospital by one craniofacial surgeon; and wide-vertex craniectomies were performed at St. Louis Children’s Hospital prior to 2010, and then continued at Children’s Medical Center Dallas. Pre- and postoperative 3D whole-head composite images were generated for each procedure to visually represent outcomes at final follow-up and compared with age-matched normal controls.
Results: Patients in the spring-assisted strip craniectomy group showed normalization of frontal bossing and skull height compared with age-matched controls, whereas patients undergoing wide-strip craniectomy showed greater correction of occipital protrusion. Patients in the narrow-strip craniectomy cohort had intermediate results between these outcomes. Nested aggregate head shapes showed good correction of head shapes from all techniques.
Conclusions: This large, retrospective, multicenter study illustrated whole head shape outcomes from three different craniectomy procedures. Although each procedure showed some differences in loci of primary correction, all three surgical methods demonstrated good correction of primary scaphocephalic deformity.
Article: Multicenter comparison of head shape outcomes for three minimally invasive strip craniectomy techniques for sagittal craniosynostosis.
Authors: Imran Rizvi BS, Rami R Hallac PhD, Emily L Geisler MD, Jeyna K Perez MS, Bar Y Ainuz MD, Mark P Pressler MD, Sarah A Jackson MS, Gary B Skolnick MBA, Matthew D. Smyth MD, James R. Seaward MD, Christopher A Derderian MD, Lisa R David MD, MBA, Christopher M Runyan MD, PhD, Kamlesh B Patel MD, MSc, and Alex A Kane MD. Atrium Health Wake Forest Baptist Hospital, St. Louis Children’s Hospital, and Children’s Medical Center Dallas, USA.