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Cited by 196Craniofacial Disorders and TreatmentsPectus Deformity Diagnosis and TreatmentReconstructive Facial Surgery Techniques

Single Sutural Craniosynostoses: Surgical Outcomes and Long-Term Growth

Fearon, Jeffrey A., Ruotolo, Rachel A., Kolar, John C.·2009·Plastic and Reconstructive Surgery
DOI 10.1097/prs.0b013e318195661a
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Abstract

BACKGROUND: This study was designed to examine long-term skull growth following single sutural synostosis corrections and to evaluate surgical outcomes. METHODS: A retrospective outcome assessment of all children treated with a single-stage, open-remodeling procedure for sagittal, metopic, unilateral coronal, and unilateral lambdoid synostosis was performed. Long-term growth was assessed from serial anthropometric measurements taken up to 11 years postoperatively (mean, 4 years). RESULTS: Of 296 consecutive patients, complete records were available for 248 operative procedures. The mean surgical age was 12.3 months (range, 2.5 months to 8 years), with 36 patients older than 12 months. Transfusion rates decreased from 81 to 19 percent following the institution of blood conservation strategies. The average hospitalization was 2.5 days. There was one nonsurgically treated infection (0.4 percent), and no major complications or deaths. Five patients underwent secondary remodeling procedures (2 percent). Serial anthropometric measurements, obtained in 75 patients, showed normalization of cranial indices 6 weeks postoperatively, but subsequent measurements revealed statistically significant diminished growth. Earlier surgical treatment of metopic synostosis (4 months) was associated with significantly more growth inhibition than seen in those treated at an older age (12 months), with the other synostoses showing similar tendencies. CONCLUSIONS: Treatment of single sutural synostosis was extremely safe with very low reoperative rates, but subsequent calvarial growth was abnormal, with a tendency toward recapitulation of the primary deformity. Growth was less diminished in procedures performed in older infants. Surgeons treating single sutural craniosynostosis should consider expanding treatment goals beyond normalization to an overcorrection of the abnormal skull shape.

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Authors
Fearon, J. A., Ruotolo, R. A., & Kolar, J. C.
Affiliations
Medical City Children's Hospital (US)
ORCID
Fearon, Jeffrey A.
Venue
Plastic and Reconstructive Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2009-02
Volume
123
Issue
2
Pages
635-642
ISSN
0032-1052 (ISSN-L)
DOI
10.1097/prs.0b013e318195661a
OpenAlex
W2051735618
Cited by
196
References
30
Citations by year
2026: 5 · 2025: 10 · 2024: 15 · 2023: 7 · 2022: 17 · 2021: 12 · 2020: 5 · 2019: 9 · 2018: 12 · 2017: 15 · 2016: 9 · 2015: 14 · 2014: 14 · 2013: 15 · 2012: 17
FWCI
6.98
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 synostosis, metopic synostosis, coronal synostosis, lambdoid synostosis, cranial index, timing of surgery, blood conservation, surgical outcomes, overcorrection
MeSH terms
Cephalometry, Child, Child, Preschool, Cranial Sutures, Craniosynostoses, Follow-Up Studies, Head, Humans, Infant, Retrospective Studies, Treatment Outcome, Plastic Surgery Procedures

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