title: Variations of endoscopic and open repair of metopic craniosynostosis.
abstract: In contrast to sagittal craniosynostosis, the role of endoscopic, minimally invasive approaches in the treatment of metopic craniosynostosis with resulting trigonocephaly is not as well defined. We reviewed the senior authors' (H.M. and S.C.) clinical experience in the treatment of children with metopic craniosynostosis using a variety of endoscopic and open techniques. Thirty-three patients were treated at a single institution during a 5-year period with between 3 and 8 years of follow-up. Sixteen patients underwent 3 variations of endoscopic approaches, and 17 patients had open fronto-orbital advancement. Clinical parameters of the 2 groups were examined including age at surgery, blood loss, operative time, transfusion volume, hospital stay, complications, use of postoperative cranial banding, and the need for reoperation for persistent deformity. The various endoscopic and open techniques used by the authors in the treatment of metopic craniosynostosis are discussed in detail, including rational for individual technique selection and preliminary impressions regarding clinical outcome.
authors.affiliation: Department of Surgery, Division of Neurosurgery, Rady Children's Hospital and Health Care Center, University of California-San Diego, 200 W. Arbor Drive, San Diego, CA 92103-8893, USA. skeshavarzi@ucsd.edu
authors.forename: Sassan
authors.initials: S
authors.lastname: Keshavarzi
authors.forename: Melanie G
authors.initials: MG
authors.lastname: Hayden
authors.forename: Sharona
authors.initials: S
authors.lastname: Ben-Haim
authors.forename: Hal S
authors.initials: HS
authors.lastname: Meltzer
authors.forename: Steven R
authors.initials: SR
authors.lastname: Cohen
authors.forename: Michael L
authors.initials: ML
authors.lastname: Levy
mesh_terms: D000367:Age Factors; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D002675:Child, Preschool; D003393:Cranial Sutures / Q000002:abnormalities* / Q000601:surgery; D003398:Craniosynostoses / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005624:Frontal Bone / Q000002:abnormalities* / Q000601:surgery; D006260:Head Protective Devices; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D009915:Orbit / Q000601:surgery; D009989:Orthotic Devices; D010027:Osteotomy / Q000379:methods; D010347:Patient Care Planning; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome