title: Differential management of scaphocephaly.
abstract: OBJECTIVE
  The objective of this study was to review the outcomes of scaphocephaly management. We hypothesized that differential treatment of scaphocephaly based on age at correction and degree of severity yields consistently satisfying results while reducing the operative morbidity.
  
  
  METHODS
  Retrospective patient record review.
  
  
  METHODS
  Three cranial vault-remodeling procedures with varying levels of aggressiveness (limited-access, partial, and total cranial-vault remodeling) were performed on patients with scaphocephaly from 1995 to 2010. More-aggressive procedures were performed on older patients and patients having more-severe deformities. Patient records were reviewed for age, weight, blood loss, and length of hospital stay, and cephalic indices (CIs) were calculated from computed tomography scans and clinical photographs.
  
  
  RESULTS
  Fifty-one patients underwent surgery for scaphocephaly during the study period. The average estimated blood volume fraction lost was 0.41. The average length of hospital stay was 4.49 days. Pre- and postoperative CIs were calculable for 36 patients. The average preoperative CI was 68.7. The average postoperative CI was 79.3, for an average operative change of 15%. The three procedures had statistically different values for average length of stay. A trend was suggested for estimated blood loss and volume fraction lost. There was no statistically significant difference in CI outcomes.
  
  
  CONCLUSIONS
  This study supports the concept of a proportionate response in the management of scaphocephaly. Less-aggressive procedures do not yield less-desirable results when properly selected to match the clinical situation of the individual patient.
authors.affiliation: Upstate Medical University, State University of New York, Syracuse, New York, USA. tatums@upstate.edu
authors.forename: Sherard A
authors.initials: SA
authors.lastname: Tatum
authors.forename: Lamont R
authors.initials: LR
authors.lastname: Jones
authors.forename: Minji
authors.initials: M
authors.lastname: Cho
authors.forename: Ranjit S
authors.initials: RS
authors.lastname: Sandhu
authors.forename: Ranjit
authors.initials: R
authors.lastname: Sandu
mesh_terms: D003398:Craniosynostoses / Q000175:diagnosis / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012886:Skull / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome