title: Benefit of piezoosteotomy in cranioplasties for craniosynostosis correction versus conventional saw-and-chisel osteotomy: a pilot study.
abstract: Pilot study evaluation of the benefit of piezoosteotomy in cranioplasty of craniosynostoses, based on clinical data.
  
  
  
  Retrospective case-control study.
  
  
  
  Universitarian institution.
  
  
  
  Craniosynostosis patients (n = 19) operated upon conventionally with a craniotome and microsaw versus 19 patients operated upon with a piezoosteotomy and a craniotome.
  
  
  
  Piezoosteotomy of the supraorbital "bandeau" and osteotomies on part of the parietal and occipital regions versus conventional saw-and-chisel osteotomy.
  
  
  
  Perioperative age, weight, laboratory parameters, transfusion and infusion requirements, operation time, and blood loss.
  
  
  
  The intraoperative erythrocyte concentrate transfusion and noncolloidal infusions were comparable (P = .15; P = .56). The fresh frozen plasma transfusion was significantly higher (P = .03); possibly, the anesthesiologist's reaction was secondary to the higher irrigation-fluid accumulation in the aspiration bag during piezoosteotomy. The postoperative erythrocyte concentrate transfusion rate was significantly lower (P = .01) as a result of local hemostasis in piezoosteotomy. The fresh frozen plasma transfusion and noncolloidal infusion volumes were nonsignificantly lower (P = .27; P = .85). Operation time was slightly shorter with a smaller standard deviation (P = .09), due to a lower rate of dural lacerations and consecutive repair; patients in the study group were on the intensive care unit half a day less (P = .73) than those in the control group. C-reactive protein was significantly lower preoperatively (P = .00) and on the operation day (P = .01) and nonsignificant postoperatively (P = .81); hematocrit was postoperatively higher (P = .23). Thrombocytes were preoperatively lower and postoperatively higher, both nonsignificant (P = .29; P = .52).
  
  
  
  Piezoosteotomy appears to be less traumatic than conventional saw-and-chisel osteotomy by the evaluated parameters. The main study limitation is its nonrandomized retrospective design; results should be confirmed by a randomized controlled trial.
authors.forename: Constantin
authors.initials: C
authors.lastname: Landes
authors.forename: Hartmut
authors.initials: H
authors.lastname: Vatter
authors.forename: Gerhard
authors.initials: G
authors.lastname: Marquardt
authors.forename: Andreas
authors.initials: A
authors.lastname: Tran
authors.forename: Florian
authors.initials: F
authors.lastname: Quo
authors.forename: Jörg
authors.initials: J
authors.lastname: Brand
authors.forename: Dirk
authors.initials: D
authors.lastname: Meininger
authors.forename: Eva
authors.initials: E
authors.lastname: Herrmann
authors.forename: Robert
authors.initials: R
authors.lastname: Sader
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D016022:Case-Control Studies; D003398:Craniosynostoses / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D059745:Piezosurgery / Q000295:instrumentation / Q000379:methods*; D010865:Pilot Projects; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Apert syndrome; Crouzon syndrome; Gorlin-Chaudhry-Moss syndrome; cranioplasty; piezoosteotomy; synostosis