title: Management options of non-syndromic sagittal craniosynostosis.
abstract: There have been various effective surgical procedures for the treatment of non-syndromic sagittal craniosynostosis, but no definitive guidelines for management have been established. We conducted a study to elucidate the current state of practice and establish a warranted standard of care. An Internet-based study was sent to 180 pediatric neurosurgeons across the country and 102 craniofacial plastic surgeons in fourteen different countries, to collect data for primary indication for surgical management, preference for timing and choice of surgery, and pre-, peri-, and post-operative management options. The overall response rate from both groups was 32% (n=90/284). Skull deformity was the primary indication for surgical treatment in patients without signs of hydrocephalus for both neurosurgeons and craniofacial surgeons (80% and 63%, respectively). Open surgical management was most commonly performed at six months of age by neurosurgeons (46%) and also by craniofacial surgeons (35%). Open surgical approach was favored for patients younger than four months of age by neurosurgeons (50%), but endoscopic approach was favored by craniofacial surgeons (35%). When performing an open surgical intervention, most neurosurgeons preferred pi or reversed pi procedure (27%), whereas total cranial vault remodeling was the most commonly performed procedure by craniofacial surgeons (37%). The data demonstrated a discrepancy in the treatment options for non-syndromic sagittal craniosynostosis. By conducting/comparing a wide survey to collect consolidative data from both groups of pediatric neurosurgeons and craniofacial plastic surgeons, we can attempt to facilitate the establishment of standard of care.
authors.affiliation: Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: bryansukbae.lee@gmail.com.
authors.forename: Bryan S
authors.initials: BS
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Lee S
authors.initials: LS
authors.lastname: Hwang
authors.affiliation: Department of Surgery, Plastic and Craniofacial Surgery, University of Montreal, Montreal, QC, Canada.
authors.forename: Gaby D
authors.initials: GD
authors.lastname: Doumit
authors.affiliation: Department of Medicine, University Hospitals, Cleveland, OH, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Wooley
authors.affiliation: Department of Plastic Surgery, Institute of Dermatology and Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Francis A
authors.initials: FA
authors.lastname: Papay
authors.affiliation: Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Luciano
authors.affiliation: Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Violette M
authors.initials: VM
authors.lastname: Recinos
mesh_terms: D002648:Child; D002675:Child, Preschool; D003398:Craniosynostoses / Q000175:diagnosis* / Q000601:surgery*; D003430:Cross-Sectional Studies; D019468:Disease Management; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D000069471:Neurosurgeons; D010808:Physical Examination / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D011795:Surveys and Questionnaires
keywords: Craniosynostosis; Non-syndromic sagittal craniosynostosis; Non-syndromic sagittal synostosis; Sagittal craniosynostosis; Sagittal synostosis