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Microscopic minimally invasive approach to nonsyndromic craniosynostosis.
J Craniofac Surg. 2009 Sep; 20(5):1492-500.JC

Abstract

PURPOSE

The purpose of this retrospective study was to present the results of the authors' microscopic minimally invasive approach in the treatment of nonsyndromic craniosynostosis.

METHODS

From 2001 to 2007, the authors treated a cohort of 67 infants with nonsyndromic sagittal, unicoronal, bicoronal, and metopic craniosynostosis, either with the microscopic (n = 40) or the open (n = 27) approach. In the microscopic approach, incisions were placed over the premature suture, and using a surgical microscope, the appropriate synostectomy was performed. The open approach used a traditional coronal incision with cranial vault reconstruction. Both groups of patients had postoperative molding helmet therapy. Finally, anthropometric measurements were used to evaluate the treatment results. The measurement used for the patients with sagittal and bicoronal craniosynostoses was the divergence from the norm of the age-adjusted cephalic index. The (FZr-EUl/FZl-EUr) and (FZr-EUr)/(FZl-EUl) were used for the patients with unicoronal craniosynostosis. The divergence from the norm of age-adjusted (FTr-FTl)/(Tr-Tl) was used for the patients with metopic craniosynostosis. (FZr = right frontozygomaticus, EUl = left eurion, FZl = left frontozygomaticus, Eur = right eurion, FTr = right frontotemporale, FTl = left frontotemporale, Tr = tragion, Tl = left tragion).

RESULTS

The median surgical times for microscopic and open approaches were 108 and 210 minutes, the volumes of blood loss were 75 and 220 mL, the durations of hospital stay were 2 and 4 days, the numbers of helmet were 2 and 1, and the durations of helmet therapy were 10.5 and 8 weeks, respectively. The analysis of variance for repeated measures showed that there was no statistically significant difference between the 2 groups in any of the craniosynostoses.

CONCLUSIONS

The treatment outcomes from the microscopic minimally invasive approach to craniosynostosis are equal to those seen with the open approach. The microscopic approach results in less operative time, blood loss, and hospitalization.

Authors+Show Affiliations

Division of Pediatric Plastic Surgery, Department of Pediatric Surgery and Orthodontics, University of Texas Health Science Center at Houston, TX, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19816284

Citation

Teichgraeber, John F., et al. "Microscopic Minimally Invasive Approach to Nonsyndromic Craniosynostosis." The Journal of Craniofacial Surgery, vol. 20, no. 5, 2009, pp. 1492-500.
Teichgraeber JF, Baumgartner JE, Waller AL, et al. Microscopic minimally invasive approach to nonsyndromic craniosynostosis. J Craniofac Surg. 2009;20(5):1492-500.
Teichgraeber, J. F., Baumgartner, J. E., Waller, A. L., Reis, S. M., Stafford, M. T., Hollinger, L. E., Gateno, J., & Xia, J. J. (2009). Microscopic minimally invasive approach to nonsyndromic craniosynostosis. The Journal of Craniofacial Surgery, 20(5), 1492-500. https://doi.org/10.1097/SCS.0b013e3181b09c4a
Teichgraeber JF, et al. Microscopic Minimally Invasive Approach to Nonsyndromic Craniosynostosis. J Craniofac Surg. 2009;20(5):1492-500. PubMed PMID: 19816284.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Microscopic minimally invasive approach to nonsyndromic craniosynostosis. AU - Teichgraeber,John F, AU - Baumgartner,James E, AU - Waller,Amy L, AU - Reis,Scott M, AU - Stafford,Marshall T, AU - Hollinger,Laura E, AU - Gateno,Jaime, AU - Xia,James J, PY - 2009/10/10/entrez PY - 2009/10/10/pubmed PY - 2010/1/29/medline SP - 1492 EP - 500 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 20 IS - 5 N2 - PURPOSE: The purpose of this retrospective study was to present the results of the authors' microscopic minimally invasive approach in the treatment of nonsyndromic craniosynostosis. METHODS: From 2001 to 2007, the authors treated a cohort of 67 infants with nonsyndromic sagittal, unicoronal, bicoronal, and metopic craniosynostosis, either with the microscopic (n = 40) or the open (n = 27) approach. In the microscopic approach, incisions were placed over the premature suture, and using a surgical microscope, the appropriate synostectomy was performed. The open approach used a traditional coronal incision with cranial vault reconstruction. Both groups of patients had postoperative molding helmet therapy. Finally, anthropometric measurements were used to evaluate the treatment results. The measurement used for the patients with sagittal and bicoronal craniosynostoses was the divergence from the norm of the age-adjusted cephalic index. The (FZr-EUl/FZl-EUr) and (FZr-EUr)/(FZl-EUl) were used for the patients with unicoronal craniosynostosis. The divergence from the norm of age-adjusted (FTr-FTl)/(Tr-Tl) was used for the patients with metopic craniosynostosis. (FZr = right frontozygomaticus, EUl = left eurion, FZl = left frontozygomaticus, Eur = right eurion, FTr = right frontotemporale, FTl = left frontotemporale, Tr = tragion, Tl = left tragion). RESULTS: The median surgical times for microscopic and open approaches were 108 and 210 minutes, the volumes of blood loss were 75 and 220 mL, the durations of hospital stay were 2 and 4 days, the numbers of helmet were 2 and 1, and the durations of helmet therapy were 10.5 and 8 weeks, respectively. The analysis of variance for repeated measures showed that there was no statistically significant difference between the 2 groups in any of the craniosynostoses. CONCLUSIONS: The treatment outcomes from the microscopic minimally invasive approach to craniosynostosis are equal to those seen with the open approach. The microscopic approach results in less operative time, blood loss, and hospitalization. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/19816284/Microscopic_minimally_invasive_approach_to_nonsyndromic_craniosynostosis_ L2 - https://doi.org/10.1097/SCS.0b013e3181b09c4a DB - PRIME DP - Unbound Medicine ER -