RESUMEN
OBJECTIVE: Surgical correction of synostotic cranial sutures is typically performed early in an affected child's life. Depending on the severity of the cranial synostoses, different aspects of the surgical treatment may have varying degrees of importance. In this sense, the aesthetic appearance in children with normal neurological development in single-suture synostosis plays an important role in self-perception and social acceptance for both the patients themselves and their caregivers. Therefore, in this study, the authors aimed to evaluate the aesthetic outcome after surgical correction in a cohort of patients with nonsyndromic sagittal suture synostosis. METHODS: Between December 2002 and December 2019, a total of 99 patients underwent surgical correction of a synostotic sagittal suture at the Medical University of Vienna. Depending on their age, patients underwent either an extended midline strip craniectomy (EMSC) (< 4 months) or a modified pi procedure (MPP) (≥ 4 months). After the surgical procedure, the outcome was evaluated by the treating neurosurgeon at 1- and 12-month follow-up visits, and after approximately 5 years, before the patient entered elementary school. In addition to that, the patients' caregivers were asked to evaluate the aesthetic outcome of the surgical procedure after 12 months. These results were then compared to evaluate potential differences in the perception of the surgical outcome. RESULTS: After 12 months, the majority of the included patients were evaluated as having a good aesthetic outcome by the treating neurosurgeon (97%) and by their caregivers (89%). These differences did not show statistical significance (p = 0.11). Similarly, no differences in the aesthetic outcome depending on the surgical procedure performed could be found (p = 0.55). At the last follow-up visit, before entering elementary school, all available patients had an excellent or good surgical outcome. Moreover, the majority of caregivers (73%) reported that their child had a normal head shape appearance after surgical correction. CONCLUSIONS: The results of this study have suggested that surgical correction of sagittal suture synostosis by simple operative techniques leads to a good aesthetic outcome and a normal head shape appearance in the majority of patients. An analysis of the evaluation of the surgical outcome by either the treating neurosurgeon or the patient caregivers showed comparable results and, thus, early intervention with simple surgical techniques can be recommended.
Asunto(s)
Craneosinostosis/cirugía , Procedimientos Neuroquirúrgicos/métodos , Suturas Craneales , Craneotomía , Femenino , Humanos , Lactante , Masculino , Procedimientos de Cirugía Plástica/métodos , Resultado del TratamientoRESUMEN
Premature sagittal suture synostosis was identified in eight specimens dated between the 18th and 20th centuries CE, of which seven are kept within the Rainer Osteological Collection in Bucharest and one was retrieved from the archaeologically investigated Saint Sava Church Cemetery. Our study focused on metric measurements, aiming to compare these specimens with three other samples comprising normal and scaphocephalic individuals, with both a Romanian and worldwide distribution. In total, 374 individuals were used in this study. However, although metric measurements clearly show that these individuals were different in their appearance, the socio-cultural data point to them being normal members of the society, as suggested by the funerary features of the archaeological specimens and their position within the Rainer Osteological Collection.