Cited by 2Craniofacial Disorders and TreatmentsPectus Deformity Diagnosis and TreatmentReconstructive Facial Surgery Techniques

Moderne Behandlung von Kraniosynostosen

Open access
Schmidt, Leon, Fassl, Verena, Erhardt, Laura, Winter, Julia, Lollert, André, Heider, Julia, Ottenhausen, Malte·2023·Monatsschrift Kinderheilkunde

Abstract

Zusammenfassung: Hintergrund: Bei 13–48 % aller Lebendgeborenen treten Auffälligkeiten der Schädelform auf. Meistens ist ein lagerungsbedingter Plagiozephalus ursächlich. Bei vorzeitigem Verschluss von Schädelnähten resultieren pathognomische Deformitäten durch das kompensatorische Wachstum der umgebenden Schädelknochen. Es muss zwischen Einzelnahtsynostosen und Kraniosynostosen im Rahmen syndromaler Erkrankungen unterschieden werden. Ziel: Diese Arbeit soll einen Überblick über Diagnostik, konservative und chirurgische Therapie von Kraniosynostosen geben. Methoden: Narratives Review. Ergebnis: Bei Verdacht auf eine Kraniosynostose erfolgt zunächst die klinische Beurteilung und Einschätzung durch erfahrene Untersucher. Die pathognomische Schädelform ergibt die Arbeitsdiagnose. Bestätigt wird diese durch Verfahren wie 3D-Stereofotografie und Sonographie. In komplexen Fällen können CT oder MRT notwendig sein. Die Indikation für eine Therapie ergibt sich aus ästhetischen Gesichtspunkten und der Vorbeugung psychosozialer Folgen. Bei syndromalen Formen besteht diese insbesondere zur Vermeidung möglicher Folgen eines erhöhten Hirndrucks. Besteht die Indikation zur Operation muss zwischen endoskopischer und offener Technik unterschieden werden. Unterschiede bestehen hier hinsichtlich Invasivität und möglichem Korrekturausmaß. Im Anschluss an die operative Behandlung schließt sich häufig eine Helmtherapie an, um das bestmögliche Ergebnis zu erreichen. Die anschließende Follow-up-Periode erstreckt sich mindestens bis zum 12. Lebensjahr. Insgesamt sollte die Behandlung im Team mit Neurochirurgen, Mund‑, Kiefer‑, Gesichtschirurgen, Kinderärzten, Augenärzten und Humangenetikern stattfinden.

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Crossref · 10.1007/s00112-022-01683-6

Cites

40 of 40 references verified0 citation errors · 0 not checkable

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  • Diagnosis of craniosynostosis is typically based on clinical examination focused on skull shape, with additional methods such as head circumference, cranial ultrasound, and 3D stereophotography, and CT or MRI reserved for complex cases.

    “The diagnosis of craniosynostosis is typically based on a clinical examination focused on skull shape. Additional methods, such as head circumference measurement, cranial ultrasound (CUS), and 3D stereophotography, may be used, with computed tomography (CT) or magnet resonance imaging (MRI) reserved for complex cases [2, 7, 8].”

    From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [2]

    In “Als erster” (page unavailable), the paper says the working diagnosis usually follows clinical assessment of skull shape; it also describes 3D stereophotography and cranial ultrasound, with CT or MRI used for complex or syndromal cases. It does not identify head-circumference measurement as an additional diagnostic method. “Nachbehandlung und Outcome” discusses head-circumference percentiles as a postoperative outcome measure instead. (LLM, conf=0.87)

    Experimental — accuracy not yet measured
  • Early diagnosis through detailed physical examination enables timely surgical intervention and helps minimise healthcare costs.

    “Early diagnosis through a detailed physical examination not only enables timely surgical intervention but also helps minimise healthcare costs, underscoring the value of clinical expertise in managing this condition [2, 27].”

    From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [2]

    The paper’s “Als erster” section describes clinical examination by an experienced examiner as the first diagnostic step. Its “Indikation” and “Nachbehandlung und Outcome” sections recommend early assessment and, in most cases where surgery is chosen, early correction. Our copy does not say that early diagnosis minimises healthcare costs (searched for Kosten and related terms). Page numbers were not available in the indexed passages. (LLM, conf=0.87)

    Experimental — accuracy not yet measured
  • Sonography up to 13 months of age can distinguish an open from a closed suture with a reported sensitivity of 100% and specificity of 86-98%, without anaesthesia.

    “sonography up to 13 months of age can distinguish an open from a closed suture with a reported sensitivity of 100% and specificity of 86–98% [2, 32], without any necessary anaesthesia.”

    From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [2]

    In “Redaktion > Als erster” (page unavailable), the paper describes sonography distinguishing open from ossified sutures, reports sensitivity of approximately 100% and specificity of 86–98%, and says it can be performed without sedation. It does not give a 13-month age limit, and its sensitivity figure is approximate rather than exactly 100%. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • Clinical evaluation alone can accurately identify craniosynostosis, eliminating the need for imaging and reducing associated risks.

    “Both Agrawal et al. and Schmidt et al. highlighted that clinical evaluation alone can accurately identify the condition, eliminating the need for imaging and reducing associated risks.”

    From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [2]

    In “Als erster” (page not provided), the paper says clinical examination usually yields a working diagnosis from the characteristic skull shape. It does not say clinical evaluation eliminates imaging: the authors use suture ultrasound for final confirmation and reserve CT or MRI mainly for complex cases. They note that avoiding CT where possible reduces radiation exposure. (LLM, conf=0.90)

    Experimental — accuracy not yet measured
  • Diagnostic confirmation typically involves measurement of head circumference, ultrasonography and, if required and technically possible, three-dimensional stereophotography.

    “Diagnostic confirmation typically involves the use of methods such as measurement of the head circumference, ultrasonography and if required and technically possible three-dimensional stereophotography.”

    From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [2]

    The diagnostic section (‘Als erster’; page unavailable) describes 3D stereophotography as established imaging and says the centre uses cranial-suture ultrasonography for final diagnostic confirmation. It describes measuring the cephalic index, not head circumference, during initial assessment; ‘Nachbehandlung und Outcome’ mentions head-circumference percentiles only as a postoperative outcome measure. The source also describes 3D scans at initial visits rather than limiting them to cases where they are required and technically possible. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

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Cites

Flagged first, then by citations

Research works printed but not linked: 7

  1. Saeed NR, Wall SA, Dhariwal DK (2008) Manage- ment of positional plagiocephaly. Arch Dis Child 93(1):82-84
  2. Di Rocco F, Arnaud E, Renier D (2009) Evolution in the frequency of nonsyndromic craniosynostosis. J Neurosurg Pediatr 4(1):21-25
  3. SuchytaMAetal(2018)Usingblackbonemagnetic resonance imaging in craniofacial virtual surgical planning: a comparative cadaver study. Plast Reconstr Surg 141(6):1459-1470
  4. Kapp-Simon KA (1998) Mental development and learning disorders in children with single suture craniosynostosis. Cleft Palate Craniofac J 35(3):197-203
  5. LangvatnEAetal(2019)Intracranialvolumeversus static and pulsatile intracranial pressure values in childrenwithcraniosynostosis. JNeurosurgPediatr 24(1):66-74
  6. Shimoji T, Tomiyama N (2004) Mild trigonocephaly and intracranial pressure: report of 56 patients. Childs Nerv Syst 20(10):749-756
  7. Fearon JA et al (1997) Infections in craniofacial surgery: acombinedreportof567proceduresfrom two centers. Plast Reconstr Surg 100(4):862-868

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Authors
Schmidt, L., Fassl, V., Erhardt, L., Winter, J., Lollert, A., Heider, J., & Ottenhausen, M.
Affiliations
  • Johannes Gutenberg University Mainz (DE)
  • University Medical Center of the Johannes Gutenberg University Mainz (DE)
Corresponding author
Schmidt, Leon
Venue
Monatsschrift Kinderheilkunde
Published
2023-01-20
ISSN
  • 0026-9298 (ISSN-L)
  • 1433-0474
OpenAlex
W4317597426
Cited by
2
References
40
Citations by year
2025: 1 · 2023: 1
FWCI
0.33
Type
journal article
Language
de
Open access
Locations
  • Monatsschrift Kinderheilkunde (publishedVersion, cc-by)
  • Gutenberg Open Science (submittedVersion, cc-by-nd)
  • Gutenberg Open Science (cc-by)
Funders
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Pectus Deformity Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
Keywords
craniosynostosis, plagiocephaly, cranial sutures, syndromic craniosynostosis, endoscopic craniosynostosis surgery, helmet therapy, cranial deformity, cranial ultrasound, multidisciplinary care

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