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A single-center experience with symptomatic postoperative calvarial growth restriction after extended strip craniectomy for sagittal craniosynostosis.
J Neurosurg Pediatr. 2010 Jan; 5(1):131-5.JN

Abstract

OBJECT

Sagittal synostosis accounts for the most common form of craniosynostosis, occurring with an incidence of 1 in 2000-5000 live births. In most cases of single-suture, nonsyndromic sagittal synostosis, a single operation is all that is required to achieve a reasonable cosmetic result. However, there are a number of patients who may experience symptomatic postoperative calvarial growth restriction secondary to fibrosis of newly formed bone and pericranium that replace the surgically removed sagittal suture, or due to fusion of other previously open sutures leading to increased intracranial pressure, necessitating a second operation.

METHODS

A retrospective review was conducted of all cases involving infants who had undergone an extended sagittal strip craniectomy with bilateral parietal wedge osteotomies at our institution between 1990 and 2006 for single-suture, nonsyndromic sagittal craniosynostosis. The frequency with which subsequent operations were required for cranial growth restriction was then defined.

RESULTS

There were a total of 164 patients with single-suture nonsyndromic sagittal synostosis. Follow-up data were available for 143 of these patients. The average age at time of initial operation was 5.25 months, and the mean duration of follow-up was 43.85 months. There were 2 patients (1.5%) who required a second operation for symptomatic postoperative calvarial growth restriction.

CONCLUSIONS

Recurrence of synostosis with resultant increased intracranial pressure in cases of single-suture, nonsyndromic sagittal craniosynostosis is an uncommon event, but does occur sporadically and unpredictably. Therefore, we recommend routine neurosurgical follow up for at least 5 years, with regular ophthalmological examinations to assess for papilledema.

Authors+Show Affiliations

Department of Neurosurgery, Children's Hospital of Pittsburgh, Pennsylvania 15201, USA. matthew.a.adamo@gmail.comNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20043748

Citation

Adamo, Matthew A., and Ian F. Pollack. "A Single-center Experience With Symptomatic Postoperative Calvarial Growth Restriction After Extended Strip Craniectomy for Sagittal Craniosynostosis." Journal of Neurosurgery. Pediatrics, vol. 5, no. 1, 2010, pp. 131-5.
Adamo MA, Pollack IF. A single-center experience with symptomatic postoperative calvarial growth restriction after extended strip craniectomy for sagittal craniosynostosis. J Neurosurg Pediatr. 2010;5(1):131-5.
Adamo, M. A., & Pollack, I. F. (2010). A single-center experience with symptomatic postoperative calvarial growth restriction after extended strip craniectomy for sagittal craniosynostosis. Journal of Neurosurgery. Pediatrics, 5(1), 131-5. https://doi.org/10.3171/2009.8.PEDS09227
Adamo MA, Pollack IF. A Single-center Experience With Symptomatic Postoperative Calvarial Growth Restriction After Extended Strip Craniectomy for Sagittal Craniosynostosis. J Neurosurg Pediatr. 2010;5(1):131-5. PubMed PMID: 20043748.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A single-center experience with symptomatic postoperative calvarial growth restriction after extended strip craniectomy for sagittal craniosynostosis. AU - Adamo,Matthew A, AU - Pollack,Ian F, PY - 2010/1/2/entrez PY - 2010/1/2/pubmed PY - 2010/2/2/medline SP - 131 EP - 5 JF - Journal of neurosurgery. Pediatrics JO - J Neurosurg Pediatr VL - 5 IS - 1 N2 - OBJECT: Sagittal synostosis accounts for the most common form of craniosynostosis, occurring with an incidence of 1 in 2000-5000 live births. In most cases of single-suture, nonsyndromic sagittal synostosis, a single operation is all that is required to achieve a reasonable cosmetic result. However, there are a number of patients who may experience symptomatic postoperative calvarial growth restriction secondary to fibrosis of newly formed bone and pericranium that replace the surgically removed sagittal suture, or due to fusion of other previously open sutures leading to increased intracranial pressure, necessitating a second operation. METHODS: A retrospective review was conducted of all cases involving infants who had undergone an extended sagittal strip craniectomy with bilateral parietal wedge osteotomies at our institution between 1990 and 2006 for single-suture, nonsyndromic sagittal craniosynostosis. The frequency with which subsequent operations were required for cranial growth restriction was then defined. RESULTS: There were a total of 164 patients with single-suture nonsyndromic sagittal synostosis. Follow-up data were available for 143 of these patients. The average age at time of initial operation was 5.25 months, and the mean duration of follow-up was 43.85 months. There were 2 patients (1.5%) who required a second operation for symptomatic postoperative calvarial growth restriction. CONCLUSIONS: Recurrence of synostosis with resultant increased intracranial pressure in cases of single-suture, nonsyndromic sagittal craniosynostosis is an uncommon event, but does occur sporadically and unpredictably. Therefore, we recommend routine neurosurgical follow up for at least 5 years, with regular ophthalmological examinations to assess for papilledema. SN - 1933-0715 UR - https://www.unboundmedicine.com/medline/citation/20043748/A_single_center_experience_with_symptomatic_postoperative_calvarial_growth_restriction_after_extended_strip_craniectomy_for_sagittal_craniosynostosis_ L2 - https://thejns.org/doi/10.3171/2009.8.PEDS09227 DB - PRIME DP - Unbound Medicine ER -