Surgical Treatment of Nonsyndromic Craniosynostosis

被引:14
|
作者
Klement, Kristen A. [1 ]
Adamson, Karri A. [1 ]
Horriat, Narges L. [1 ]
Denny, Arlen D. [1 ]
机构
[1] Med Coll Wisconsin, Dept Plast Surg, Milwaukee, WI 53226 USA
关键词
Craniosynostosis; outcomes; sagittal synotosis; METOPIC SYNOSTOSIS; TRANSCRANIAL SURGERY; CRANIOFACIAL SURGERY; COMPLICATIONS; OUTCOMES; VOLUME;
D O I
10.1097/SCS.0000000000003950
中图分类号
R61 [外科手术学];
学科分类号
摘要
Studies on the treatment of nonsyndromic craniosynostosis demonstrate decreasing morbidity and mortality; however, complication rates still range from 5% to 14%. Here, the authors present their last 10 years' experience treatment of nonsyndromic single suture craniosynostosis. A retrospective review was performed on patients who underwent open surgical treatment of nonsyndromic craniosynostosis over 10 years. Patient characteristics and clinical outcomes were reviewed. Radiological analysis of intracranial volumes was performed using Amira software. The authors' technique for treatment of sagittal synostosis was the Foreshortening and Lateral Expansion of the Cranium Activated by Gravity (FLAG) procedure. The authors identified 106 patients with a median age of 0.8 years. Sagittal synostosis was most common (n=65, 61%). Seventeen percent underwent distraction of the cranial vault; the remainder underwent traditional remodeling procedures. The average operative time was 131 minutes, blood loss was 296mL (30mL/kg), and intraoperative transfusion was 332mL (34mL/kg). There were 2 postoperative complications. Six patients required an additionalmajor operation years later, most commonly for increased intracranial pressure. The authors separately analyzed 50 patients with sagittal synostosis treated with the FLAG procedure. There were no postoperative complications, and only 4 patients required reoperation. The average operative time for the FLAG procedure was 97.3 minutes. Intracranial volume increased by 191.45mL (28.3-427.5mL) with 28% average relative cranial vault expansion (4.5%-93.2%). Surgical correction of craniosynostosis using the FLAG technique is safe and effective with minimalmorbidity and long standing results. Treatment should involve a structured approach, which minimizes operative times and decreases complication rates.
引用
收藏
页码:1752 / 1756
页数:5
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