Spring-mediated cranioplasty compared with the modified pi-plasty for sagittal synostosis.
The aim of this study was to compare the safety, morphological outcome, and degree of parental satisfaction of the new spring-mediated cranioplasty with those of the modified pi-plasty in the management of sagittal synostosis. Ten patients with non-syndromic sagittal synostosis treated with the spring-mediated cranioplasty were followed prospectively. A control group of 10 sex-matched patients operated on with the modified pi-plasty procedure was chosen. Cephalometric radiographs were obtained preoperatively and postoperatively at 1 year of age. Cephalic index, axial width ratio, length ratio, width ratio and height ratio were used as objective measures of outcome. Parents were sent a questionnaire to obtain a subjective aesthetic assessment of outcome. Significantly less blood replacement was required (p = 0.003), and shorter duration of postoperative anaesthesia (p = 0.030) and postoperative hospital stay (p = 0.013) were found in the spring-mediated cranioplasty group. There were no complications or deaths in either group. Also significant was the inter-group difference in the postoperative change in the height ratio (p = 0.030), the most change being seen in the spring group. The change in the subjective parental aesthetic evaluation of skull shape was significant in both groups. In conclusion, the spring-mediated procedure was morphologically more effective than the modified pi-plasty procedure in the management of sagittal synostosis with the additional benefits of less blood transfusion needed and shorter duration of hospital stay.
Guimarães-Ferreira
José
J
Institute of Human Anatomy, and Department of Plastic Surgery, University of Lisbon School of Medicine, Lisbon, Portugal. ferreira@medfak.gu.se
Gewalli
Fredrik
F
David
Lisa
L
Olsson
Robert
R
Friede
Hans
H
Lauritzen
Claes G K
CG
D002508:Cephalometry; D003398:Craniosynostoses / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012886:Skull / Q000601:surgery*