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Regression of cephalic index following endoscopic repair of sagittal synostosis.
- Source :
-
Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2019 Jan 01; Vol. 23 (1), pp. 54-60. Date of Electronic Publication: 2018 Oct 05. - Publication Year :
- 2019
-
Abstract
- OBJECTIVEMetrics used to quantify preoperative severity and postoperative outcomes for patients with sagittal synostosis include cephalic index (CI), the well-known standard, and the recently described adjusted cephalic index (aCI), which accounts for altered euryon location. This study tracks the time course of these measures following endoscopic repair with orthotic helmet therapy. The authors hypothesize that CI and aCI show significant regression following endoscope-assisted repair.METHODSCT scans or 3D photographs of patients with nonsyndromic sagittal synostosis treated before 6 months of age by endoscope-assisted strip craniectomy and postoperative helmet therapy (n = 41) were reviewed retrospectively at three time points (preoperatively, 0-2 months after helmeting, and > 24 months postoperatively). The CI and aCI were measured at each time point.RESULTSMean CI and aCI increased from 71.8 to 78.2 and 62.7 to 72.4, respectively, during helmet treatment (p < 0.001). At final follow-up, mean CI and aCI had regressed significantly from 78.2 to 76.5 and 72.4 to 69.7, respectively (p < 0.001). The CI regressed in 33 of 41 cases (80%) and aCI in 39 of 41 cases (95%). The authors observed a mean loss of 31% of improvement in aCI achieved through treatment. A strong, positive correlation existed between CI and aCI (R = 0.88).CONCLUSIONSRegression following endoscope-assisted strip craniectomy with postoperative helmet therapy commonly occurs in patients with sagittal synostosis. Future studies are required to determine whether duration of helmet therapy or modifications in helmet design affect regression.
- Subjects :
- Craniosynostoses diagnostic imaging
Endoscopy methods
Humans
Infant
Photography methods
Postoperative Period
Retrospective Studies
Skull diagnostic imaging
Skull growth & development
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Craniosynostoses surgery
Craniotomy methods
Head Protective Devices
Orthotic Devices
Severity of Illness Index
Subjects
Details
- Language :
- English
- ISSN :
- 1933-0715
- Volume :
- 23
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of neurosurgery. Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 30497205
- Full Text :
- https://doi.org/10.3171/2018.7.PEDS18195