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Sagittal synostotic twins: reverse pi procedure for scaphocephaly correction gives superior result compared to endoscopic repair followed by helmet therapy.
J Craniofac Surg. 2008 Nov; 19(6):1453-8.JC

Abstract

A unique situation of twins with similar sagittal synostosis pathology who underwent different surgical corrective procedures allowed us an opportunity to compare an endoscopic technique to the more traditional technique of a modified cranial vault remodeling (CVR). At 4 months of age, 1 twin underwent an endoscopic-assisted extended strip craniectomy with postoperative helmet therapy for 12 months, and the other underwent a reverse pi CVR procedure. Cephalic index, the Whitaker Aesthetic score, and developmental tests were used for comparison during a 6-year follow-up. The modified CVR had a superior outcome compared to the endoscopic procedure with regard to cephalic index measurements (CVR = 77; endoscopic = 63; P < 0.05) and the Whitaker score (CVR = 1 or no revisions necessary; endoscopic = 2.3 or minor to major bony work required for correction). Patients had similar intelligence quotient test scores; however, the endoscopic patient had lower scores in both preschool tests and global evaluations compared with the normal scores of the CVR patient. The modified CVR procedure was superior to the endoscopic procedure, at least in these twins with sagittal synostosis.

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Authors+Show Affiliations

Kohan E
Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at University of California, USA.
Wexler A
No affiliation info available
Cahan L
No affiliation info available
Kawamoto HK
No affiliation info available
Katchikian H
No affiliation info available
Bradley JP
No affiliation info available

MeSH

AttentionBone RemodelingCephalometryCranial SuturesCraniosynostosesCraniotomyDiseases in TwinsEndoscopyEstheticsFollow-Up StudiesHead Protective DevicesHumansInfantIntelligenceMaleMemoryOccipital BoneParentsParietal BonePersonal SatisfactionTreatment OutcomeTwins

Pub Type(s)

Case Reports
Comparative Study
Journal Article

Language

eng

PubMed ID

19098532

Citation

Kohan, Emil, et al. "Sagittal Synostotic Twins: Reverse Pi Procedure for Scaphocephaly Correction Gives Superior Result Compared to Endoscopic Repair Followed By Helmet Therapy." The Journal of Craniofacial Surgery, vol. 19, no. 6, 2008, pp. 1453-8.
Kohan E, Wexler A, Cahan L, et al. Sagittal synostotic twins: reverse pi procedure for scaphocephaly correction gives superior result compared to endoscopic repair followed by helmet therapy. J Craniofac Surg. 2008;19(6):1453-8.
Kohan, E., Wexler, A., Cahan, L., Kawamoto, H. K., Katchikian, H., & Bradley, J. P. (2008). Sagittal synostotic twins: reverse pi procedure for scaphocephaly correction gives superior result compared to endoscopic repair followed by helmet therapy. The Journal of Craniofacial Surgery, 19(6), 1453-8. https://doi.org/10.1097/SCS.0b013e3181897390
Kohan E, et al. Sagittal Synostotic Twins: Reverse Pi Procedure for Scaphocephaly Correction Gives Superior Result Compared to Endoscopic Repair Followed By Helmet Therapy. J Craniofac Surg. 2008;19(6):1453-8. PubMed PMID: 19098532.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sagittal synostotic twins: reverse pi procedure for scaphocephaly correction gives superior result compared to endoscopic repair followed by helmet therapy. AU - Kohan,Emil, AU - Wexler,Andrew, AU - Cahan,Les, AU - Kawamoto,Henry K, AU - Katchikian,Hurig, AU - Bradley,James P, PY - 2008/12/23/entrez PY - 2008/12/23/pubmed PY - 2009/4/1/medline SP - 1453 EP - 8 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 19 IS - 6 N2 - A unique situation of twins with similar sagittal synostosis pathology who underwent different surgical corrective procedures allowed us an opportunity to compare an endoscopic technique to the more traditional technique of a modified cranial vault remodeling (CVR). At 4 months of age, 1 twin underwent an endoscopic-assisted extended strip craniectomy with postoperative helmet therapy for 12 months, and the other underwent a reverse pi CVR procedure. Cephalic index, the Whitaker Aesthetic score, and developmental tests were used for comparison during a 6-year follow-up. The modified CVR had a superior outcome compared to the endoscopic procedure with regard to cephalic index measurements (CVR = 77; endoscopic = 63; P < 0.05) and the Whitaker score (CVR = 1 or no revisions necessary; endoscopic = 2.3 or minor to major bony work required for correction). Patients had similar intelligence quotient test scores; however, the endoscopic patient had lower scores in both preschool tests and global evaluations compared with the normal scores of the CVR patient. The modified CVR procedure was superior to the endoscopic procedure, at least in these twins with sagittal synostosis. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/19098532/Sagittal_synostotic_twins:_reverse_pi_procedure_for_scaphocephaly_correction_gives_superior_result_compared_to_endoscopic_repair_followed_by_helmet_therapy_ L2 - https://doi.org/10.1097/SCS.0b013e3181897390 DB - PRIME DP - Unbound Medicine ER -