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SPRING-MEDIATED CRANIOPLASTY COMPARED WITH THE MODIFIED PI-PLASTY FOR SAGITTAL SYNOSTOSIS
Authors:José Guimarães-Ferreira  Fredrik Gewalli  Lisa David  Robert Olsson  Hans Friede  Claes G K Lauritzen
Institution:1. Institute of Human Anatomy, and Department of Plastic Surgery University of Lisbon School of Medicine Lisbon Portugal;2. Department of Plastic Surgery Sahlgrenska University Hospital G?teborg Sweden;3. Department of Plastic Surgery Wake Forest University Baptist Medical Center Winston-Salem NC USA;4. Department of Neurosurgery Sahlgrenska University Hospital G?teborg Sweden;5. Department of Orthodontics G?teborg University G?teborg Sweden
Abstract:The aim of this study was to compare the safety, morphological outcome, and degree of parental satisfaction of the new spring-mediated cranioplasty with those of the modified pi-plasty in the management of sagittal synostosis. Ten patients with non-syndromic sagittal synostosis treated with the spring-mediated cranioplasty were followed prospectively. A control group of 10 sex-matched patients operated on with the modified pi-plasty procedure was chosen. Cephalometric radiographs were obtained preoperatively and postoperatively at 1 year of age. Cephalic index, axial width ratio, length ratio, width ratio and height ratio were used as objective measures of outcome. Parents were sent a questionnaire to obtain a subjective aesthetic assessment of outcome. Significantly less blood replacement was required (p?=?0.003), and shorter duration of postoperative anaesthesia (p?=?0.030) and postoperative hospital stay (p?=?0.013) were found in the spring-mediated cranioplasty group. There were no complications or deaths in either group. Also significant was the inter-group difference in the postoperative change in the height ratio (p?=?0.030), the most change being seen in the spring group. The change in the subjective parental aesthetic evaluation of skull shape was significant in both groups. In conclusion, the spring-mediated procedure was morphologically more effective than the modified pi-plasty procedure in the management of sagittal synostosis with the additional benefits of less blood transfusion needed and shorter duration of hospital stay.
Keywords:Cephalometry  Sagittal Synostosis  Craniosynostoses/pathology/radiography/surgery  Surgery  Plastic/methods
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