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Cranial Base and Posterior Cranial Vault Asymmetry After Open and Endoscopic Repair of Isolated Lambdoid Craniosynostosis.
- Source :
-
The Journal of craniofacial surgery [J Craniofac Surg] 2015 Jul; Vol. 26 (5), pp. 1568-73. - Publication Year :
- 2015
-
Abstract
- Background: Previous studies have shown that open cranial vault remodeling does not fully address the endocranial deformity. This study aims to compare endoscopic-assisted suturectomy with postoperative molding helmet therapy to traditional open reconstruction by quantifying changes in cranial base morphology and posterior cranial vault asymmetry.<br />Methods: Anthropometric measurements were made on pre- and 1-year postoperative three-dimensionally reconstructed computed tomography scans of 12 patients with unilateral lambdoid synostosis (8 open and 4 endoscopic-assisted). Cranial base asymmetry was analyzed using: posterior fossa deflection angle (PFA), petrous ridge angle (PRA), mastoid cant angle (MCA), and vertical and anterior-posterior (A-P) displacement of external acoustic meatus (EAM). Posterior cranial vault asymmetry was quantified by volumetric analysis.<br />Results: Preoperatively, patients in the open and endoscopic groups were statistically equivalent in PFA, PRA, MCA, and A-P EAM displacement. At 1 year postoperatively, open and endoscopic patients were statistically equivalent in all measures. Mean postoperative PFA for the open and endoscopic groups was 6.6 and 6.4 degrees, PRA asymmetry was 6.4 and 7.6%, MCA was 4.0 and 3.2 degrees, vertical EAM displacement was -2.3 and -2.3 millimeters, and A-P EAM displacement was 6.8 and 7.8 millimeters, respectively. Mean volume asymmetry was significantly improved in both open and endoscopic groups, with no difference in postoperative asymmetry between the 2 groups (Pā=ā0.934).<br />Conclusions: Patients treated with both open and endoscopic repair of lambdoid synostosis show persistent cranial base and posterior cranial vault asymmetry. The results of endoscopic-assisted suturectomy with postoperative molding helmet therapy are similar to those of open calvarial vault reconstruction.
- Subjects :
- Cephalometry methods
Child, Preschool
Combined Modality Therapy
Cranial Sutures surgery
Craniosynostoses pathology
Ear Canal pathology
Follow-Up Studies
Head Protective Devices
Humans
Imaging, Three-Dimensional methods
Infant
Mastoid pathology
Occipital Bone surgery
Parietal Bone surgery
Petrous Bone pathology
Retrospective Studies
Skull Base surgery
Tomography, X-Ray Computed methods
Craniosynostoses surgery
Endoscopy methods
Occipital Bone pathology
Plastic Surgery Procedures methods
Skull Base pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1536-3732
- Volume :
- 26
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The Journal of craniofacial surgery
- Publication Type :
- Academic Journal
- Accession number :
- 26114505
- Full Text :
- https://doi.org/10.1097/SCS.0000000000001891