title: Surgical outcome after using a modified technique of the pi-procedure for posterior sagittal suture closure.
abstract: Fusion of the sagittal suture is the most prevalent form of craniosynostosis. Due to the variety of deformities of scaphocephaly depending on the location of the fused sagittal suture, the surgical procedure has to be adjusted to the individual case. In this study, 38 patients with a predominantly posterior sagittal suture closure were treated with a modified technique of the pi-procedure and the surgical outcome has been evaluated with respect to complications, morphological and aesthetic outcome. The improvement of the cephalic index in our series in the follow-up examination (mean 60.1 months) after surgery was significant (p<0.0001). According to the classification of Whitaker, 31 patients had a Class 1 outcome, with excellent surgical results. Aesthetic outcomes were excellent in 29, good in 5, and poor in 4 of cases, as judged by both the families and the craniofacial team. No severe complications have been observed. Posterior sagittal suture with marked occipital bulging can be successfully treated with this modified posterior procedure with a low complication rate, significant improvement of the cephalic index and a good aesthetic outcome. In all cases of sagittal synostosis, the operative procedure should be tailored to the nature and severity of the deformity.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Michael.engel@med.uni-heidelberg.de
authors.forename: M
authors.initials: M
authors.lastname: Engel
authors.forename: C
authors.initials: C
authors.lastname: Freudlsperger
authors.forename: J
authors.initials: J
authors.lastname: Hoffmann
authors.forename: J
authors.initials: J
authors.lastname: Mühling
authors.forename: G
authors.initials: G
authors.lastname: Castrillón-Oberndorfer
authors.forename: R
authors.initials: R
authors.lastname: Seeberger
mesh_terms: D016063:Blood Loss, Surgical; D002508:Cephalometry / Q000379:methods; D003393:Cranial Sutures / Q000601:surgery*; D003398:Craniosynostoses / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D010027:Osteotomy / Q000379:methods; D010294:Parietal Bone / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome