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Cited by 51Craniofacial Disorders and TreatmentsPectus Deformity Diagnosis and TreatmentTraumatic Brain Injury and Neurovascular Disturbances

Mental Development After Modified ?? Procedure: Dynamic Cranioplasty for Sagittal Synostosis

Gewalli, Fredrik, da Silva Guimar??es-Ferreira, Jos?? Paulo, Sahlin, Pelle, Emanuelsson, Ingrid, Horneman, G??ran, Stephensen, Hannes, Lauritzen, Claes G. K.·2001·Annals of Plastic Surgery
DOI 10.1097/00000637-200104000-00011
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Abstract

A prospective developmental assessment was performed on 26 patients operated on with dynamic cranioplasty for sagittal synostosis. Because this technique entails the application of compressive force, it was of great concern to assess the effect of surgery on development and mental status. The surgical technique used was a modified pi procedure. Perioperative variables were recorded. Six patients underwent preoperative intracranial pressure (ICP) measurements. To evaluate objectively the developmental outcome, the Griffiths' Mental Development Scales was used for analysis before and after surgery. A parental questionnaire was used for subjective outcome measurement. Preoperative ICP recordings during sleep ranged from 12.8 to 22.8 mmHg (mean, 16.1 mmHg). The mean age at the time for surgery was 6.9 months (range, 4-16 months; standard deviation [SD], 2.32 months). The surgical technique included shortening of the anteroposterior diameter of the skull by a mean of 16.6 mm. The mean global development quotient (GDQ) preoperatively was 104.5 (range, 82-144; SD, 12.4) and the mean GDQ postoperatively was 101.4 (range, 62-129; SD, 13.6). Mean age at follow-up was 16.3 months (range, 9-40 months; SD, 4.04 months). There was no significant correlation between the amount of intraoperative shortening and mental development. In comparison of means, the GDQ preoperatively did not differ significantly from the GDQ postoperatively. The modified pi procedure is safe and efficient. When surgery was performed before 1 year of age, no significant (p = 0.33) effect on mental development-either detrimental or beneficial-was demonstrated.

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  • The difference in developmental delay between elevated and normal ICP was not statistically significant; there was a trend suggesting a negative association between ICP and cognitive development, which has been questioned by several other authors.

    “Although the difference was not statistically significant, there was a trend suggesting a negative association between ICP and cognitive development, which has been questioned by several other authors in the past [34].”

    From Isolated Sagittal Craniosynostosis: A Comprehensive Review (2024) · cites this paper as [34]

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Authors
Gewalli, F., da Silva Guimar??es-Ferreira, J. P., Sahlin, P., Emanuelsson, I., Horneman, G., Stephensen, H., & Lauritzen, C. G. K.
Affiliations
Sahlgrenska University Hospital (SE)
Corresponding author
  • Gewalli, Fredrik
  • Sahlin, Pelle
  • Stephensen, Hannes
  • Lauritzen, Claes G. K.
Venue
Annals of Plastic Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2001-04
Volume
46
Issue
4
Pages
415-420
ISSN
0148-7043 (ISSN-L)
DOI
10.1097/00000637-200104000-00011
OpenAlex
W2059027082
Cited by
51
References
29
Citations by year
2024: 2 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 5 · 2019: 4 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 5 · 2014: 3 · 2013: 1 · 2012: 4
FWCI
0.55
Type
journal article
Language
en
Open access
closed
Locations
  • Annals of Plastic Surgery (publishedVersion)
  • PubMed (publishedVersion)
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 › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
Keywords
sagittal synostosis, craniosynostosis, cognitive development, developmental outcomes, intracranial pressure, infants
MeSH terms
Child Development, Child, Preschool, Craniosynostoses, Craniotomy, Female, Follow-Up Studies, Humans, Infant, Intracranial Pressure, Male, Neuropsychological Tests, Parents, Postoperative Complications, Prospective Studies, Psychometrics, Surveys and Questionnaires

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