The DOI matches its Crossref record; 11 of the 11 references it cites were found in a registry or an index.
The Diagnosis and Treatment of Single-Sutural Synostoses: Are Computed Tomographic Scans Necessary?
Abstract
BACKGROUND: Computed tomographic scan evaluation is the current standard of care for diagnosing craniosynostosis. Recent publications, and the National Cancer Institute, have raised concerns about ionizing radiation associated with computed tomographic scans in children (e.g., developmental delays, tumor induction). The authors sought to ascertain the diagnostic accuracy of the physical examination in evaluating single-sutural craniosynostosis and assess the need for computed tomographic scans in surgical correction. METHODS: This prospective, multicenter, outcome assessment included children clinically diagnosed with a single-sutural synostosis by craniofacial surgeons (with 1 to 18 years' experience) at four centers over a 1-year period. Clinical diagnoses were compared with computed tomographic scan evaluations. All surgeons scored the utility of computed tomographic scans during surgical repair. RESULTS: Sixty-seven patients were clinically diagnosed with single-sutural craniosynostosis (mean age, 7 months; range, 1 week to 48 months). Sixty-six of 67 patients were diagnosed with craniosynostosis by computed tomographic scan (sagittal, 40 percent; metopic, 31 percent; right unilateral coronal, 16 percent; left unilateral coronal, 6 percent; and right lambdoid, 6 percent), for a diagnostic accuracy exceeding 98 percent. One patient with suspected lambdoid synostosis was radiologically diagnosed with positional plagiocephaly. Three of four craniofacial surgeons scored computed tomographic scans as "unnecessary" for surgical correction; one scored scans as "sometimes helpful." CONCLUSIONS: Craniofacial surgeons with various experience levels were able to accurately diagnose single-sutural synostosis by physical examination alone. Considering potential side effects from ionizing radiation, risks of sedation, and costs, surgeons may wish to reserve computed tomographic scans only for infants with suspected single-sutural craniosynostosis in whom the physical examination is not clearly diagnostic.
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“Fearon et al. in 2007 demonstrated that CT imaging is unnecessary due to the condition’s clear clinical detectability and the associated risk of radiation exposure.”
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 [29]
In the citing paper
“In 66 of 67 children, the findings of the clinical and radiological examinations were similar in their description and associated diagnosis.”
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 [29]
Citations
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Tradeoffs between image quality and dose
Seibert, J. A. (2004) · Pediatric Radiology · doi:10.1007/s00247-004-1268-7 · Cited by 77
Ultrasound screening of the lambdoid suture in the child with posterior plagiocephaly
Sze, R. W., Parisi, M. T., Sidhu, M. K., Paladin, A. M., Ngo, A.-V. H., Seidel, K. D., Weinberger, E., Ellenbogen, R. G., Gruss, J. S., & Cunningham, M. L. (2003) · Pediatric Radiology · doi:10.1007/s00247-003-1009-3 · Cited by 59
High-resolution sonography of the abnormal cranial suture
Soboleski, D., Mussari, B., McCloskey, D., Sauerbrei, E. E., Espinosa, F., & Fletcher, A. (1998) · Pediatric Radiology · doi:10.1007/s002470050297 · Cited by 44
Gamache, G. L., Levinson, D. M., Reeves, D., BIDYUK, P., & BRANTLEY, K. (2004) · Archives of Clinical Neuropsychology · doi:10.1016/j.acn.2004.03.005 · Cited by 40
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Single Sutural Craniosynostoses: Surgical Outcomes and Long-Term Growth
Fearon, J. A., Ruotolo, R. A., & Kolar, J. C. (2009) · Plastic and Reconstructive Surgery · doi:10.1097/prs.0b013e318195661a · Cited by 196
Self-citationOutcome 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
“In light of the recent publications on the possible risks of radiation exposure in early childhood, we do not think that serial computed tomography for the sole purpose of quantifying clinical results is warranted.(23) Further study is ongoing to refine our measurement capabilities without radiation exposure.”
BackgroundEley, K. A., Watt-Smith, S. R., Sheerin, F., & Golding, S. J. (2014) · European Radiology · doi:10.1007/s00330-014-3286-7 · Cited by 136
Garza, R. M., & Khosla, R. K. (2012) · Seminars in Plastic Surgery · doi:10.1055/s-0032-1320063 · Cited by 129
Vogel, T. W. A., Woo, A. S., Kane, A. A., Patel, K. B., Naidoo, S. D., & Smyth, M. D. (2014) · Journal of Neurosurgery Pediatrics · doi:10.3171/2013.12.peds13320 · Cited by 104
Metadata
- Authors
- Fearon, J. A., Singh, D. J., Beals, S. P., & Yu, J. C.
- Affiliations
- Augusta University (US)
- Venue
- Plastic and Reconstructive Surgery
- Published
- 2007-10
- Volume
- 120
- Issue
- 5
- Pages
- 1327-1331
- ISSN
- 0032-1052 (ISSN-L)
- OpenAlex
- W2002200350
- Cited by
- 119
- References
- 11
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 7 · 2023: 1 · 2022: 8 · 2021: 17 · 2020: 7 · 2019: 8 · 2018: 7 · 2017: 10 · 2016: 8 · 2015: 6 · 2014: 4 · 2013: 7 · 2012: 5
- FWCI
- 2.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Plastic & Reconstructive Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Craniofacial Disorders and Treatments
- Health Sciences › Medicine › Surgery › Pectus Deformity Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Keywords
- physical examination, computed tomography, ionizing radiation risk, craniofacial surgery, surgical planning, positional plagiocephaly, lambdoid synostosis, coronal synostosis, metopic synostosis, sagittal synostosis, infants
- MeSH terms
- Child, Preschool, Craniosynostoses, Female, Humans, Infant, Infant, Newborn, Male, Physical Examination, Prospective Studies, Tomography, X-Ray Computed, Outcome Assessment, Health Care
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