Craniosynostosis: a single institution's outcome assessment from surgical reconstruction.
OBJECTIVE
A retrospective review of a single institution's 20-year experience of complications and reoperation rates after surgery for primary craniosynostosis correction.


METHODS
A retrospective chart review of all patients (n = 376) undergoing primary surgery for craniosynostosis was conducted. The charts were analyzed for diagnosis, sex, syndromic involvement, age at operation, type of fixation, complications, and reoperations. Complications were defined as any event requiring prolonged hospitalization or readmission secondary to the surgical procedure, reoperation, or mortality. Reoperative rates were classified into major (e.g., repeat craniotomy, cranioplasty) or minor (e.g., hardware removal, wound closure).


RESULTS
After excluding patients for length of follow-up less than 6 months (n = 23), inadequate verification of all data (n = 21), and prior neurosurgical craniectomy (n = 18), a total of 314 patients were identified. The percentage of patients with complications and reoperations was 39.2% (n = 123). The rates of major reoperation (n = 72), minor reoperation (n = 41), and various complications (n = 10) were 22.9%, 13.1%, and 3.2%, respectively. No mortalities were identified.


CONCLUSIONS
Differing types of fixation, diagnosis of syndrome, and multiple-suture craniosynostosis were statistically correlated to increased reoperative rates. Age at initial operation and sex were not correlated to increased reoperative rates. Finally, this institution's complication and reoperative rates compare with other published results.
Pearson
Gregory D
GD
Ohio State University Plastic and Reconstructive Surgery, School of Medicine, 410 W. 10th Avenue, Columbus, OH 43210, USA. gregory.pearson@osumc.edu
Havlik
Robert J
RJ
Eppley
Barry
B
Nykiel
Matthew
M
Sadove
A Michael
AM
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003398:Craniosynostoses / Q000145:classification / Q000175:diagnosis / Q000601:surgery*; D003399:Craniotomy; D020878:Device Removal; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D009984:Orthopedic Fixation Devices; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000592:standards*; D012086:Reoperation; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome