Single Sutural Craniosynostoses: Surgical Outcomes and Long-term Growth

摘要

This long-term outcome assessment showed that growth is not normal following surgical correction for the single sutural synostoses. Surgeons should consider over-correction of the observed deformity. Following single sutural synostosis corrections, parents are typically advised to expect normal growth. We sought to examine outcomes and to assess long-term growth for all the single sutural synostoses following surgical correction. The records of 296 children with single sutural synostosis were retrospectively reviewed to determine outcomes. All patients were treated with a single-stage, open remodeling procedure. Long-term growth was assessed from an-thropologic measurements taken up to 11 years postoperatively (mean > 4 years). Of 296 consecutive patients, complete records were available for 221 operative procedures. The surgical age ranged from 2 months to 8 years (mean 12 months). Following the institution of preoperative erythropoietin administration and use of a cell saver for blood recycling (2001), the overall transfusion rate decreased from 81% to 19% of patients, and the average hospitalization was < 2.5 days. There were no deaths or major complications, and there was only 1 non-surgically treated infection (0.5%). Five patients underwent secondary remodeling procedures (2%). Early postoperative anthropologic measurements showed complete correction, or over-correction, of the presenting deformity. Subsequent measurements revealed that growth was not normal: children with trigonocephaly demonstrated less than predicted bifrontal growth and head circumference, children with plagiocephaly had significantly less growth in head circumference, and children with scaphocephaly showed a regression of the cephalic index.