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Evolution of surgery for sagittal synostosis: the role of new technologies.
J Craniofac Surg. 2009 Jan; 20(1):129-33.JC

Abstract

BACKGROUND

Techniques for sagittal synostosis correction continue to evolve to improve outcomes and minimize morbidity. The techniques now used by our craniofacial service are spring-assisted cranioplasty for younger children (generally up to 9 months of age) and biparietal barrel staving with cross-struts using bioabsorbable plates for older children. We evaluate the evolution of, and rationale for, our current methods of treatment.

METHOD

All patients who underwent surgery for craniosynostosis over the period 1982 to 2007 were retrospectively reviewed. Patients with sagittal synostosis were analyzed according to the type of operative procedure performed. Blood loss, operative time, and hospital stay were compared between techniques using analysis of variance.

RESULTS

Seventy-one patients had a cranial vault remodeling procedure for craniosynostosis. Thirty-four patients had sagittal synostosis with scaphocephaly. During the period 1982 to 2000, 13 patients had a strip craniectomy, and 5 patients had a barrel stave and morcellation procedure. Since 2001, the cross-strut technique using bioabsorbable plates has been used in 7 patients. In 2005, the spring cranioplasty technique was introduced and has been used in 9 patients. There were no deaths and no serious complications. One patient treated with springs had a second spring procedure performed to further increase biparietal width. Spring-assisted cranioplasty had a significantly shorter operating time than other techniques (P < 0.01).

CONCLUSION

The availability of both absorbable plates and expansile cranial springs has revolutionized the techniques our unit uses for scaphocephaly correction. Our early experience with these techniques has shown that the techniques are reliable and give good cranial shape and form with minimal treatment morbidity.

Authors+Show Affiliations

Departments of Plastic Surgery and daggerNeurosurgery, Christchurch Hospital, Christchurch, New Zealand.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19165009

Citation

Mackenzie, Katarzyna A., et al. "Evolution of Surgery for Sagittal Synostosis: the Role of New Technologies." The Journal of Craniofacial Surgery, vol. 20, no. 1, 2009, pp. 129-33.
Mackenzie KA, Davis C, Yang A, et al. Evolution of surgery for sagittal synostosis: the role of new technologies. J Craniofac Surg. 2009;20(1):129-33.
Mackenzie, K. A., Davis, C., Yang, A., & MacFarlane, M. R. (2009). Evolution of surgery for sagittal synostosis: the role of new technologies. The Journal of Craniofacial Surgery, 20(1), 129-33. https://doi.org/10.1097/SCS.0b013e318190e1cf
Mackenzie KA, et al. Evolution of Surgery for Sagittal Synostosis: the Role of New Technologies. J Craniofac Surg. 2009;20(1):129-33. PubMed PMID: 19165009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evolution of surgery for sagittal synostosis: the role of new technologies. AU - Mackenzie,Katarzyna A, AU - Davis,Charles, AU - Yang,Arthur, AU - MacFarlane,Martin R, PY - 2009/1/24/entrez PY - 2009/1/24/pubmed PY - 2009/5/8/medline SP - 129 EP - 33 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 20 IS - 1 N2 - BACKGROUND: Techniques for sagittal synostosis correction continue to evolve to improve outcomes and minimize morbidity. The techniques now used by our craniofacial service are spring-assisted cranioplasty for younger children (generally up to 9 months of age) and biparietal barrel staving with cross-struts using bioabsorbable plates for older children. We evaluate the evolution of, and rationale for, our current methods of treatment. METHOD: All patients who underwent surgery for craniosynostosis over the period 1982 to 2007 were retrospectively reviewed. Patients with sagittal synostosis were analyzed according to the type of operative procedure performed. Blood loss, operative time, and hospital stay were compared between techniques using analysis of variance. RESULTS: Seventy-one patients had a cranial vault remodeling procedure for craniosynostosis. Thirty-four patients had sagittal synostosis with scaphocephaly. During the period 1982 to 2000, 13 patients had a strip craniectomy, and 5 patients had a barrel stave and morcellation procedure. Since 2001, the cross-strut technique using bioabsorbable plates has been used in 7 patients. In 2005, the spring cranioplasty technique was introduced and has been used in 9 patients. There were no deaths and no serious complications. One patient treated with springs had a second spring procedure performed to further increase biparietal width. Spring-assisted cranioplasty had a significantly shorter operating time than other techniques (P < 0.01). CONCLUSION: The availability of both absorbable plates and expansile cranial springs has revolutionized the techniques our unit uses for scaphocephaly correction. Our early experience with these techniques has shown that the techniques are reliable and give good cranial shape and form with minimal treatment morbidity. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/19165009/Evolution_of_surgery_for_sagittal_synostosis:_the_role_of_new_technologies_ L2 - https://doi.org/10.1097/SCS.0b013e318190e1cf DB - PRIME DP - Unbound Medicine ER -