OPEN RECONSTRUCTIVE METHOD OF SURGICAL TREATMENT OF NONSYNDROMIC CRANIOSYNOSTOSIS IN CHILDREN
Abstract
Objective: to demonstrate the outcomes of open reconstructive surgical interventions for treatment of various types of non-syndromic craniosynostosis in children.
Material and methods: authors performed 57 open reconstructive operations to treat the various types of craniosynostosis from January 2014 till June 2016. Age of children varied from 6 months till 11 years old. The wide decompression of parietal lobes was performed in case of sagittal craniosynostosis. The bilateral frontoparietal reconstruction with reposition of frontoorbital complex is required for treatment of one- and two-sided coronal craniosynostosis. Frontoorbitoparietal reconstruction was performed in case of metopic craniosynostosis, parietooccipital reconstruction was used in case of one-sided posterior plagiocephaly. Algorithms for ordinary craniosynostoses surgery were applied for treatment of combined disease of cranial sutures. Preoperatively all patients underwent multispiral computer tomoghraphy with 3D-reconstruction for estimation of synostosis type, craniometrics values and intracranial volume. Treatment outcomes were estimated in 1 year using L.A. Whitacker scale.
Results. Postoperatively intracranial volume was increased in varied ranges in depends on patients’ age and types of craniosynostosis according to CT-volumetry data. Values of cephalic index in case of scaphocephaly were increased up to 6% in average, changes of frontal angle in case of trigonocephaly — about 12%, asymmetry coefficient of cranial vault in case of plagiocephaly changed to 47%. The good treatment outcome was observed in 89,5% of cases, satisfactiry — in 10,5% according to L.A. Whitacker scale.
Conclusions. Surgical treatment outcomes in patients underwent open reconstructive operations demonstrate the prevention of development or reversal of intracranial hypertension and deformation of child’s head. The achievement of esthetic effect was observed after operation at once.
About the Authors
G. V. Letyagin
ФГБУ «Федеральный центр нейрохирургии».
Russian Federation
Russian Federation
S. A. Kim
ФГБУ «Федеральный центр нейрохирургии».
Russian Federation
Russian Federation
V. E. Danilin
ФГБУ «Федеральный центр нейрохирургии».
Russian Federation
Russian Federation
A. A. Sysoeva
ФГБУ «Федеральный центр нейрохирургии».
Russian Federation
Russian Federation
M. N. Amelin
ФГБУ «Федеральный центр нейрохирургии».
Russian Federation
Russian Federation
References
1. Lehrbuch der pathologischen anatomie des menchen und der Thiere. Berlin: Ruecker, 1830.
2. Persing J.A., Jane J.A., Shaffrey M. Virchow and pathogenesis of craniosynostosis: a translation of his original work. Plast Reconstr Surg 1989; 83(4):738-742.
3. Marsh J.M., Gurley J.M., Kane A.A. Nonsyndromic craniosynostosis. Philadelphia, PA: Saunders Elsevier; 2006:135-164.
4. Persing J.A. Management considerations in thetreatment of craniosynostosis. Plast Reconstr Surg. 2008;121(4, Suppl):1-11.
5. Yagnik G., Ghuman A., Kim S., et al. ALX4 gain-offunction mutations in nonsyndromic craniosynostosis. Hum Mutat 2012;33(12): 1626—1629.
6. Boulet S.L., Rasmussen S.A., Honein M.A. A population — based study of craniosynostosis in metropolitan Atlanta, 1989-2003. Am J Med Genet A 2008; 146A: 984— 991.
7. Lin I.C., Slemp A.E., Hwang C., et al. Immunolocalization of androgen receptor in the developing craniofacial skeleton. J Craniofac Surg. 2004;15:922—927; discussion 928.
8. Kolar J.S. Anepidemiological study of nonsyndromal craniosynostoses. J Craniofac Surg 2011;22(1): 47-49.
9. Rekate H.L. Occipital plagiocephaly: a critical review of the literature. J Neurosurg 1998;89(1): 24-30.
10. Size R.W., Hopper R.A., Ghioni V. et al. MDKT diagnosis of the child with posterior plagiocephaly. AJR Am J Roentgenol 2005;185(5):1342—1346.
11. Ploplus E.A., Hopper R.A., Muzaffar A. R. et al. Comparison of computed tomographic imaging measurements with clinical findings in children with unilateral lambdoid synostosis. Plast Reconstr Surg 2009;123(1):300-309.
12. Ananov M.V., Roginskij V.V., Satanin L.A., Zubajraev M.S Краниосиностозы. Moscow: Detstomizdat; 2002 (in Russian)
13. Meier P.M., Goobie S.M., DiNardo J.A., et al. Endoscopics tripcraniectomy in early infancy: Theinitial five years of anesthesia experience. Anesth Analg 2011;112:407—414.
14. Shah M.N., Kane A.A., Petersen J.D., et al. Endoscopically assisted versus open repair of sagittal craniosynostosis: The St. Louis Children’s Hospital experience. J Neurosurg Pediatr 2011;8:165—170.
15. Panchal J., Marsh J.L., Park T.S., et al. Sagittal craniosynostosis outcome assessment for two methods and timings of intervention. Plast Reconstr Surg 1999;103:1574—1584.
16. Marsh J. L., Jenny A., Galic M., et al. Surgical management of sagittal synostosis: A quantitative evaluation of two techniques. Neurosurg Clin N Am 1991;2:629—640.
17. Ramesh Kumar Sharma. Craniosynostosis. Indian J Plast Surg 2013;46(1):18—27.
18. Satanin L.A., Gorelyshev S.K. Guidelines «Surgical treatment of nonsyndromic cranyiosynostosis in children». Moscow; 2015. (in Russian)
19. Vannier M. W., Hildebolt C. F., Marsh J. L., et al. Craniosynostosis: Diagnostic value of three-dimensional CT reconstruction. Radiology 1989; 173:669—673.
20. Taylor H., Ramakrishnan A., Forrest C. Advances in the diagnosis of craniosynostosis. EurJPediatr 2010; 4:66—71.
21. Homutov A. E. Antropology. Rostov-on-Don: Feniks; 2004. (in Russian).
22. Yagain V.K., Pai S.R., Kalthur S.G., et al. Hemalatha study of cephalic index in Indian students. International Journal of Morphology 2012;30(1):125—129.
23. Van der Meulen J. On Trigonocephaly. Dissertation. Rotterdam: Erasmus University, 2009. P. 31—38.
24. Ebel K.D., Benz-Bohm G. Differential Diagnosis in Pediatric Radiology. Thieme, 1998, p. 551.
25. Meyer-Marcotty P., Bohm H., Linz C., et al. Head orthesis therapy in infants with unilateral positional plagiocephaly: an interdisciplinary approach to broadening the range of orthodontic treatment. J Orofac Orthop 2012;73:151—165.
26. Han R.H., Nguyen D.C., Bruck B.S., et al. Characterization of Complications Associated with Open and Endoscopic Craniosynostosis Surgery at a Single Institution. J Neurosurg Pediatr 2016;17(3):361—370.
27. Tamburrini G., Caldarelli M., Santini P., DiRocco C. Intracranial pressure monitoring in children with single suture and complex craniosynostosis: are view. Childs Nerv Syst 2005; 21(10):913—921.
28. Shimoji T., Tomiyama N. Mild trigonocephaly and intracranial pressure: report of 56 patients. Childs Nerv Syst 2004;20:749— 756.
29. Sgouros S., Hockley A. D., Goldin J. H., et al. Intracranial volume change in craniosynostosis. J Neurosurg 1999;91(4):615— 625.
30. Gault D.T., Renier D., Marchac D., Jones B.M. Intracranial pressure and intracranial volume in children with craniosynostosis. Plast Reconstr Surg 1992;90(3):377—381.
31. Renier D., Sainte-Roze C., Marchac D., Hirsch J. F. Intracranial pressure in craniosynostosis. J Neurosurg 1982; 57(3):370—377.
32. Thompson D.N., Harkness W., Jones B., et al. Subdural intracranial pressure monitoring in craniosynostosis: it role in surgical management. Childs Nerv Syst 1995;11(5):269—275.
33. Aldridge K., Kane A. A., Marsh J. L. et al. Brain morphology in nonsyndromic unicoronal craniosynostosis. Anat Rec A DiscovMol Cell Evol Biol 2005; 285(2):690—698.
34. Aldridge K., Kane A.A., Marsh J.L., et al. Relationship of brain and skull in pre — and postoperative sagittal synostosis. J Anat 2005;206(4):373—385.
35. Becker D.B., Petersen J.D., Kane A.A., et al. Speech, cognitive, and behavioral outcomes in nonsyndromic craniosynostosis. Plast Reconstr Surg 2005;116(2):400—407.
36. Kapp-Simon K.A., Speltz M.L., Cuningham M.L., et al. Neurodevelopment of children with single suture craniosynostosis: a review. Childs Nerv Syst 2007;23(3):269— 281.
37. Shipster C., Hearst D., Somerville A., et al. Speech, language, and cognitive development in children with isolated sagittal synostosis. Dev Med Child Neurol 2003;45(1):34—43.
38. Bottero L., Lajeunie E., Arnaud E., et al. Functional outcome after surgery for trigonocephaly. Plast Reconstr Surg 1998;102(4):952—958. Discussion 959—960.
39. Kelleher M.O., Murray D.J., McGilivary A. et al. Behavioral, developmental, and educational problems in children with nonsyndromic trigonocephaly. J Neurosurg 2006;105(5, Suppl):382—384.
40. Garza R.M., Khosla R.K. Nonsyndromic Craniosynostosis. Semin Plast Surg 2012;26(2):53—63.
41. Seruya M., Oh A.K., Boyajian M.J. et al. Long-term outcomes of primary craniofacial reconstruction for craniosynostosis: a 12-year experience. Plast Reconstr Surg 2011; 127(6):2397— 2406.
42. Wall S.A., Goldin J.H., Hockley A.D., et al. Frontoorbital re-operation in craniosynostosis. Br J Plast Surg 1994;47(3):180—184.
43. Sufianov A.A., Gaibov S.S-H., Sufianov R.A., Ivanova N.E. The clinical picture of nonsyndromic craniosynostosis in children. Zhurnal nevrologii i psihiatrii 2015; 8: 18-22 (in Russian).
44. Nguyen C., Hernandez-Boussard T., Khosla R., Curtin C. A national study on craniosynostosis surgical repair. Cleft Palate Craniofac J 2013;50(5): 555—560.
45. Esparza J., Hinojosa J. Complications in the surgical treatment of craniosynostosis and craniofacial syndromes: Apropos of 306 transcranial procedures. Childs Nerv Syst 2008;24:1421— 30.
Review
For citations:
Letyagin G.V., Kim S.A., Danilin V.E., Sysoeva A.A., Amelin M.N. OPEN RECONSTRUCTIVE METHOD OF SURGICAL TREATMENT OF NONSYNDROMIC CRANIOSYNOSTOSIS IN CHILDREN. Russian journal of neurosurgery. 2017;(4):50-58. (In Russ.)
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