Logo image
Back
Timing of cranial vault remodeling in nonsyndromic craniosynostosis: a single-institution 30-year experience
Journal article   Peer reviewed

Timing of cranial vault remodeling in nonsyndromic craniosynostosis: a single-institution 30-year experience

Alan F Utria, Joseph Lopez, Regina S Cho, Gerhard S Mundinger, George I Jallo, Edward S Ahn, Craig Vander Kolk and Amir H Dorafshar
Journal of neurosurgery. Pediatrics, Vol.18(5), pp.629-634
11/2016
DOI: 10.3171/2016.5.peds1663
PMID: 27503248
url
https://doi.org/10.3171/2016.5.peds1663View
Published (Version of record) Open Access

Related content

Has comment

Abstract

OBJECTIVE Due to the changing properties of the infant skull, there is still no clear consensus on the ideal time to surgically intervene in cases of nonsyndromic craniosynostosis (NSC). This study aims to shed light on how patient age at the time of surgery may affect surgical outcomes and the subsequent need for reoperation. METHODS A retrospective cohort review was conducted for patients with NSC who underwent primary cranial vault remodeling between 1990 and 2013. Patients' demographic and clinical characteristics and surgical interventions were recorded. Postoperative outcomes were assessed by assigning each procedure to a Whitaker category. Multivariate logistic regression analysis was performed to determine the relationship between age at surgery and need for minor (Whitaker I or II) versus major (Whitaker III or IV) reoperation. Odds ratios (ORs) for Whitaker category by age at surgery were assigned. RESULTS A total of 413 unique patients underwent cranial vault remodeling procedures for NSC during the study period. Multivariate logistic regression demonstrated increased odds of requiring major surgical revisions (Whitaker III or IV) in patients younger than 6 months of age (OR 2.49, 95% CI 1.05-5.93), and increased odds of requiring minimal surgical revisions (Whitaker I or II) in patients older than 6 months of age (OR 2.72, 95% CI 1.16-6.41). CONCLUSIONS Timing, as a proxy for the changing properties of the infant skull, is an important factor to consider when planning vault reconstruction in NSC. The data presented in this study demonstrate that patients operated on before 6 months of age had increased odds of requiring major surgical revisions.
 Cohort Studies Cranial Sutures - pathology Craniosynostoses - diagnosis Craniosynostoses - surgery Female Follow-Up Studies Humans Infant Male Reconstructive Surgical Procedures - methods Reconstructive Surgical Procedures - trends Reoperation - methods Reoperation - trends Retrospective Studies Time Factors

Details

Metrics

8 Record Views
Logo image