Sagittal craniosynostosis: Surgical outcomes and long-term growth
Abstract
BACKGROUND: Numerous publications have examined technique-specific results in treating sagittal synostosis, but there are scant data examining long-term outcomes. This retrospective study was designed to evaluate a large series of surgically repaired children with sagittal craniosynostosis and to examine long-term cranial growth following correction. METHODS: From 1990 to 2003, 132 children with sagittal synostosis were evaluated and 89 surgically treated (single-stage posterior remodeling) patients were retrospectively reviewed (43 were excluded for multisutural involvement, incomplete records, or nonsurgical treatment). Long-term growth was assessed from anthropologic measurements taken from 3 to 11 years postoperatively (mean, 4.7 years). RESULTS: The surgical age ranged from 2 months to 5 years (mean, 8 months), and the hospital stay was less than 3 days. There were no deaths, major complications, infections, or repeated remodeling procedures performed. Postoperatively, the cephalic index was overcorrected. Subsequent growth of the cranial breadth and length was less than predicted. Moreover, growth was more deficient in cranial breadth than length, resulting in a regression of the cephalic index over time (p < 0.01). Frontal breadth improved immediately postoperatively but did not subsequently narrow over time. Head circumference also showed a statistically significant diminished capacity for growth (p < 0.001). CONCLUSIONS: This study demonstrated abnormal skull growth in children following the surgical correction of scaphocephaly. On the basis of these findings, surgeons treating sagittal synostosis may wish to expand their goals of treatment beyond normalization to an overcorrection of the abnormal skull shape.
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Endoscopic procedures have the advantage of requiring fewer skin incisions and less blood loss and are considered less invasive and more child-friendly.
“They have the advantage of requiring fewer skin incisions and less blood loss and are therefore considered less invasive and more child-friendly [64,65,66,67,68,69,70].”
From Isolated Sagittal Craniosynostosis: A Comprehensive Review (2024) · cites this paper as [64]
Cites
Endoscopic craniectomy for early surgical correction of sagittal craniosynostosis
Jimenez, D. F., & Barone, C. M. (1998) · Journal of Neurosurgery · doi:10.3171/jns.1998.88.1.0077 · Cited by 364 · see citing works
LANE, L. C. (1892) · JAMA · doi:10.1001/jama.1892.02411060019001f · Cited by 235 · see citing works
Immediate correction of sagittal synostosis
Jane, J. A., Edgerton, M. T., Futrell, J. W., & Park, T. S. (1978) · Journal of neurosurgery · doi:10.3171/jns.1978.49.5.0705 · Cited by 191 · see citing works
Sagittal craniosynostosis outcome assessment for two methods and timings of intervention
Panchal, J., Marsh, J. L., Park, T. S., Kaufman, B., Pilgram, T., & Huang, S. H. (1999) · Plastic and Reconstructive Surgery · doi:10.1097/00006534-199905000-00004 · Cited by 159 · see citing works
Fearon, J. A., & Weinthal, J. A. (2002) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-200206000-00002 · Cited by 125 · see citing works
Self-citationPosnick, J. C., Lin, K. Y. K., Chen, P., & Armstrong, D. C. (1993) · PubMed · Cited by 123 · see citing works
Surgical Management of Sagittal Synostosis
Marsh, J. L., Jenny, A. B., Galić, M., Picker, S., & Vannier, M. W. (1991) · Neurosurgery Clinics of North America · doi:10.1016/s1042-3680(18)30724-1 · Cited by 110 · see citing works
Surgical management of sagittal synostosis. A quantitative evaluation of two techniques.
Marsh, J. L., Jenny, A. B., Galić, M., Picker, S., & Vannier, M. W. (1991) · PubMed · Cited by 104 · see citing works
Maugans, T. A., McComb, G., & Levy, M. L. (2008) · Pediatric Neurosurgery · doi:10.1159/000121241 · Cited by 84 · see citing works
Reducing Allogenic Blood Transfusions during Pediatric Cranial Vault Surgical Procedures:
Fearon, J. A. (2004) · Plastic & Reconstructive Surgery · doi:10.1097/01.prs.0000110324.31791.5c · Cited by 83 · see citing works
Self-citationThe Coronal Incision Revisited
Munro, I. R., & Fearon, J. A. (1994) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-199401000-00031 · Cited by 72 · see citing works
Self-citationOutcome analysis of 85 patients undergoing the pi procedure for correction of sagittal synostosis
Boop, F. A., Chadduck, W. M., Shewmake, K., & Teo, C. (1996) · Journal of neurosurgery · doi:10.3171/jns.1996.85.1.0050 · Cited by 72 · see citing works
Posnick, J. C., Lin, K. Y., Chen, P., & Armstrong, D. (1993) · Plastic and Reconstructive Surgery · doi:10.1097/00006534-199311000-00003 · Cited by 70 · see citing works
Przybylo, H. J., & Przybylo, J. H. (2003) · Plastic & Reconstructive Surgery · doi:10.1097/01.prs.0000063134.27372.45 · Cited by 69 · see citing works
Clinical Outcome of the Modified Pi-Plasty Procedure for Sagittal Synostosis
Guimãraes-Ferreira, J., Gewalli, F., David, L. R., Olsson, R. J., Friede, H., Lauritzen, C. G. K., Longaker, M. T., & Hemmy, D. C. (2001) · Journal of Craniofacial Surgery · doi:10.1097/00001665-200105000-00003 · Cited by 62 · see citing works
Wilkie, A. O. M., & Wall, S. A. (1996) · Current Opinion in Neurology · doi:10.1097/00019052-199604000-00016 · Cited by 56 · see citing works
Weinzweig, J., Baker, S. B., Whitáker, L. A., Sutton, L. N., & Bartlett, S. P. P. (2002) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-200208000-00003 · Cited by 49 · see citing works
Synostectomy versus complex cranioplasty for the treatment of sagittal synostosis
Boop, F. A., Shewmake, K., & Chadduck, W. M. (1996) · Child s Nervous System · doi:10.1007/bf00395087 · Cited by 48 · see citing works
Surgical Correction of Sagittal Craniosynostosis
Kanev, P. M., & Lo, A. K. M. (1995) · Journal of Craniofacial Surgery · doi:10.1097/00001665-199503000-00002 · Cited by 46 · see citing works
Sagittal synostosis: results of surgical treatment in 210 patients
Álvarez-Garijo, J. A., Cavadas, P. C., Vila, M. M. V., & Álvarez-Llanas, A. (2001) · Child s Nervous System · doi:10.1007/s003810000353 · Cited by 46 · see citing works
Surgical Treatment of Sagittal Synostosis
Olds, M. V., Storrs, B. B., & Walker, M. L. (1986) · Neurosurgery · doi:10.1227/00006123-198603000-00016 · Cited by 45 · see citing works
The Reversal Exchange Technique of Total Calvarial Reconstruction for Sagittal Synostosis
Fata, J. J., & Turner, M. S. (2001) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-200106000-00001 · Cited by 32 · see citing works
Rigid Fixation of the Calvaria in Craniosynostosis without Using “Rigid” Fixation
Fearon, J. A. (2003) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-200301000-00005 · Cited by 31 · see citing works
Self-citationOccipital Reduction – Biparietal Widening Technique for Correction of Sagittal Synostosis
McComb, G. (2008) · Pediatric Neurosurgery · doi:10.1159/000120772 · Cited by 27 · see citing works
Friede, H., Lauritzen, C. G. K., & Figueroa, A. A. (1996) · Journal of Craniofacial Surgery · doi:10.1097/00001665-199603000-00002 · Cited by 26 · see citing works
Rigid Fixation of the Calvaria in Craniosynostosis without Using “Rigid” Fixation
Fearon, J. A. (2003) · Plastic & Reconstructive Surgery · doi:10.1097/01.prs.0000036261.99248.09 · Cited by 25 · see citing works
Self-citationSurgical Correction of Severe Scaphocephalic Deformities
Burstein, F. D., Hudgins, R. J., Cohen, S. R., & Boydston, W. R. (1994) · Journal of Craniofacial Surgery · doi:10.1097/00001665-199409000-00006 · Cited by 25 · see citing works
Surgical treatment of premature sagittal synostosis
Filho, G. P. (1997) · Arquivos de Neuro-Psiquiatria · doi:10.1590/s0004-282x1997000300008 · Cited by 3 · see citing works
Further delineation of the acro-renal-ocular syndrome
(1996) · Pure Amsterdam UMC · doi:10.1002/(sici)1096-8628(19960329)62:3 · Cited by 1 · see citing works
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Fearon, J. A., Ruotolo, R. A., & Kolar, J. C. (2009) · Plastic and Reconstructive Surgery · doi:10.1097/prs.0b013e318195661a · Cited by 196 · see citing works
Self-citationBerry-Candelario, J., Ridgway, E. B., Grondin, R. T., Rogers, G. F., & Proctor, M. R. (2011) · Neurosurgical FOCUS · doi:10.3171/2011.6.focus1198 · Cited by 134 · see citing works
Outcome analysis of our first 75 spring-assisted surgeries for scaphocephaly
David, L. R., Plikaitis, C. M., Couture, D., Glazier, S. S., & Argenta, L. C. (2010) · Journal of Craniofacial Surgery · doi:10.1097/scs.0b013e3181c3469d · Cited by 136 · see citing works
An Appraisal of the Cephalic Index in Sagittal Craniosynostosis, and the Unseen Third Dimension
Fearon, J. A., Ditthakasem, K., Herbert, M., & Kolar, J. (2017) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000003422 · Cited by 83 · see citing works
Self-citationThomas, G. P. L., Johnson, D., Byren, J. C., Judge, A. D., Jayamohan, J., Magdum, S. A., Richards, P. G., & Wall, S. A. (2015) · Journal of Neurosurgery Pediatrics · doi:10.3171/2014.11.peds1426 · Cited by 81 · see citing works
Isolated sagittal craniosynostosis: definition, classification, and surgical indications
Massimi, L., Caldarelli, M., Tamburrini, G., Paternoster, G., & Di Rocco, C. (2012) · Child s Nervous System · doi:10.1007/s00381-012-1834-5 · Cited by 76 · see citing works
Isaac, K. V., Meara, J. G., & Proctor, M. R. (2018) · Journal of Neurosurgery: Pediatrics · doi:10.3171/2018.5.peds1846 · Cited by 64 · see citing works
van Veelen, M.-L. C., Eelkman Rooda, O. H. J., de Jong, T., Dammers, R., van Adrichem, L. N. A., & Mathijssen, I. M. J. (2013) · Child s Nervous System · doi:10.1007/s00381-013-2024-9 · Cited by 61 · see citing works
van Veelen, M.-L. C., Mihajlović, D., Dammers, R., Lingsma, H., van Adrichem, L. N. A., & Mathijssen, I. M. J. (2015) · Journal of Neurosurgery: Pediatrics · doi:10.3171/2014.12.peds14260 · Cited by 27 · see citing works
Isolated Sagittal Craniosynostosis: A Comprehensive Review
Spazzapan, P., & Velnar, T. (2024) · Diagnostics · doi:10.3390/diagnostics14040435 · Cited by 24 · see citing works
“They have the advantage of requiring fewer skin incisions and less blood loss and are therefore considered less invasive and more child-friendly [64–70].”
BackgroundEpidemiology of Hospital Admissions for Craniosynostosis in Australia: A Population-Based Study
Junaid, M., Slack-Smith, L., Wong, K., Baynam, G., Calache, H., Hewitt, T., & Leonard, H. (2023) · The Cleft Palate Craniofacial Journal · doi:10.1177/10556656221074215 · Cited by 9 · see citing works
“Individuals born with syndromic CS, however, have prolonged service contacts when compared to those born with single suture synostosis.(27,6) As most syndromic CS has an underlying genetic cause, better access to genetic diagnostic testing may provide an opportunity for increasing the precision of service planning.”
BackgroundMicovic, M., Zivkovic, B., Bascarevic, V., Mijalčić, R., & Rasulic, L. (2016) · Neurosurgical Review · doi:10.1007/s10143-015-0661-z · Cited by 8 · see citing works
Moderne Behandlung von Kraniosynostosen
Schmidt, L., Fassl, V., Erhardt, L., Winter, J., Lollert, A., Heider, J., & Ottenhausen, M. (2023) · Monatsschrift Kinderheilkunde · doi:10.1007/s00112-022-01683-6 · Cited by 2 · see citing works
- Authors
- Fearon, J. A., McLaughlin, E. B., & Kolar, J. C.
- Affiliations
- Medical City Dallas Hospital (US)
- ORCID
- Fearon, Jeffrey A.
- Venue
- Plastic and Reconstructive Surgery
- Published
- 2006-02
- Volume
- 117
- Issue
- 2
- Pages
- 532-541
- ISSN
- 0032-1052 (ISSN-L)
- OpenAlex
- W2085657752
- Cited by
- 146
- References
- 29
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 6 · 2023: 12 · 2022: 11 · 2021: 10 · 2020: 9 · 2019: 5 · 2018: 10 · 2017: 11 · 2016: 7 · 2015: 11 · 2014: 9 · 2013: 5 · 2012: 5
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Plastic & Reconstructive 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 › Surgery › Reconstructive Facial Surgery Techniques
- Keywords
- sagittal craniosynostosis, scaphocephaly, cephalic index, cranial breadth, cranial length, head circumference, overcorrection
- MeSH terms
- Child, Preschool, Craniosynostoses, Craniotomy, Humans, Infant, Length of Stay, Osteotomy, Postoperative Period, Retrospective Studies, Skull, Treatment Outcome, Plastic Surgery Procedures
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